Maternal and Child Health Commons^™

A Qualitative Study Of Pregnancy And Maternal Mortality In Rural Senegal: An Examination Of The Pregnant Woman’S Experience, Megan Frances Harlow

Independent Study Project (ISP) Collection

Much prior research has focused on the problem of maternal mortality in Senegal, the factors that cause it, and the numerical trends that indicate either decline or increase in maternal mortality. Few studies, however, have captured the mentality, attitudes, or beliefs of Senegalese women in rural areas, or the rationality behind their behaviors during pregnancy, which ultimately have implications for the alleged contributors to maternal mortality. I conducted the bulk of my field research in Saraya, a small town in southeastern Senegal. Through study of prenatal consultation records, participant observation in multiple settings, and interviews with healthcare practitioners and recent …

The Realization Of The Rights To Health, Education And Social Welfare Among Disabled Youth In Ingwavuma And Bhambanana, Kwazulu Natal, Ali Mumford

Independent Study Project (ISP) Collection

This practicum based study was completed in an effort to explore the realization of the rights to health, education and social welfare for disabled children in Ingwavuma and Bhambana, KwaZulu Natal. Very little research has been done on disabled children in South Africa, and estimations of prevalence range from 3.3-6.4%. The absence of accurate data creates a situation where implementation of policy and delivery of services is slow and does not always address the most urgent needs. The new South Africa aimed to bring rights and freedom to all groups of people, but the question which this study attempts to …

Buscando La Luz: Changes In Partería And The Loss Of Feminine Autonomy In Oaxaca, Mexico, Hannah Ewert-Krocker

Independent Study Project (ISP) Collection

Birth is one of the most fundamental moments of every human being’s life, and women have long been honored in the world’s societies as sacred and vital due to their important roles as life-givers. Because of the importance of birth in the lives and societies of human beings, birth and birthing practices can reveal many values of a culture and of the women within that culture and also demonstrate how and why those values are changing. The choices women make between traditional health care and more “modern” Western models are almost always influenced by the socio-economic and cultural conditions of …

Southern Nevada Health District Childhood Lead Poisoning Prevention Program Lead Poisoning Elimination Plan, Southern Nevada Health District, Strategic Advisory Coalition

Nevada Institute for Children's Research and Policy Reports

On August 2, 2006, the Southern Nevada Health District (SNHD) was awarded a 5-year grant by the Center for Disease Control and Prevention (CDC) under its Childhood Lead Poisoning Prevention Program (CLPPP). The grant award was unprecedented in the State of Nevada and was made available to the SNHD via approval from the State to act as its bona fide agent. The primary goal of the grant was to develop this Childhood Lead Poisoning Strategic Elimination Plan (EP) in support of CDC’s overarching goal of eliminating childhood lead poisoning by the year 2010.

Planning Initiative Award – 2006-2007 Access To Reproductive Health Services For Low-Ses Pregnant/Parenting Teens In Clark County: A Comprehensive Needs Assessment, Nevada Institute For Children's Research And Policy Reports, Jennifer Zipoy, Tara Swanson, Jean Henry, Denise Tanata, Uzma Farmanali,, Karen Silcott

Nevada Institute for Children's Research and Policy Reports

The Planning Initiative Award (PIA) project was a collaborative effort between the Nevada Institute for Children’s Research and Policy (NICRP) and the Center for Health Promotion (CHP)/Department of Health Promotion, research centers in the School of Public Health. The purpose of the project was to conduct an assessment of the access to reproductive health services among lower SES pregnant and parenting teens in the Las Vegas Valley. The project was designed to identify gaps in existing services and assist researchers in developing communication networks between community members, providers, educators, and policymakers. The data collected during the project period has great …

Psychometric Evaluation Of An Instrument For Assessing Policy Outcomes For Families With Children Who Have Severe Developmental Disabilities: The Beach Center Family Quality Of Life Scale, Joni Taylor Mcfelea

Health Services Research Dissertations

The purpose of the study was to evaluate the psychometric properties of the Beach Center Family Quality of Life Scale (BCFQLS) in a sample of families with children who have severe developmental disabilities. The study sought to determine whether or not the scale could be used to measure the quality of life of such families and to differentiate between the quality of life of two family groups—those whose child lives in the family home and those whose child lives outside the family home.

The study used an observational, cross-sectional design and both qualitative and quantitative methods. Self-identified primary caregivers of …

Rethinking The Body Mass Index Initiative, Sarah C. Mckenzie, Gary W. Ritter

Policy Briefs

In February 2005, the Office for Education Policy published a fact sheet detailing Arkansans’ attitudes toward the Body Mass Index initiative (BMI) and found that the state was roughly divided on the issue. Since 2005, the results of BMI screening have been chronicled in a pair of government reports, and the General Assembly has acted to modify how BMI testing is undertaken. In this policy brief we outline what the research indicates after three years of BMI testing, and how the laws surrounding BMI have changed.

Low-Income Minority Mothers’ Reports Of Infant Health Care Utilisation Compared With Medical Records, Kennan D. Murray, Ayman El-Mohandes, M. Nabil El-Khorazaty, Michele Kiely

Publications and Research

This study aimed to investigate mothers’ reporting of the nature, location, frequency and content of health care visits for their infants, as compared with data abstracted from the infants’ medical records. It was part of a community-based parenting intervention designed to improve preventive health care utilisation among minority mothers in Washington, DC. Mothers 18 years old with newborn infants and with poor or no prenatal care were enrolled in the study. A total of 160 mother–infant dyads completed the 12-month study. Mothers were interviewed when the infants were 4, 8 and 12 months old, and were asked to recall infant …

Messages Of Maternity: The Relationship Of State And Ngo Institutions To Reproductive Health Services And The Construction Of Family In Jordan, Julia Shatz

Independent Study Project (ISP) Collection

This project examines the ways in which family planning and reproductive health services and the institutions that provide them contribute to constructing definitions of family and motherhood in Jordan. The study is based on personal interviews conducted with representatives at six institutions – the Ministry of Health, the Higher Population Council, the Jordanian Association for Family Planning and Protection, Queen Zein Al Sharaf Institute for Development, the Arab Women’s Organization, and the Jordanian Women’s Union. This paper addresses the issues of family planning as a method of population control, the integrated medical and educational approach currently popular in family planning …

A Case Study Of Pediatric Diarrhea At Murchison District Hospital In Port Shepstone, Kwazulu-Natal, South Africa, T. Smith

Independent Study Project (ISP) Collection

This study investigates pediatric diarrhea in children under 5 years old at Murchison District Hospital in Port Shepstone, South Africa. Hospital Child Pip data was used to determine the number of admissions to the hospital for pediatric diarrhea and its mortality rate. Characteristics of deceased patients including age, malnutrition, and HIV status, were then synthesized with information on patients’ access to clean water and improved sanitation obtained through 20 interviews of mothers of patients as well as caregivers’ infant feeding practices and hygiene practices, such as handwashing with soap. Treatment and prevention of diarrhea was also explored. Murchison’s management of …

Well Child Health Care In Wales: A Change Of Setting, A Shift Of Power, Jennifer Herman

Inquiry Journal 2007

No abstract provided.

Ambulatory Care Adverse Events And Preventable Adverse Events Leading To A Hospital Admission, Donna M Woods, Eric J Thomas, Jane L Holl, Kevin B Weiss, Troyen A Brennan

Faculty, Staff and Student Publications

BACKGROUND: Most healthcare in the US is delivered in the ambulatory care setting, but the epidemiology of errors and adverse events in ambulatory care is understudied.

METHODS: Using the population-based data from the Colorado and Utah Medical Practices Study, we identified adverse events that occurred in an ambulatory care setting and led to hospital admission. Proportions with 95% CIs are reported.

RESULTS: We reviewed 14,700-hospital discharge records and found 587 adverse events of which 70 were ambulatory care adverse events (AAEs) and 31 were ambulatory care preventable adverse events (APAEs). When weighted to the general population, there were 2608 AAEs …

Kematian Perinatal Di Indonesia Dan Faktor Yang Berhubungan, Tahun 1997-2003, Meidy Farenti Prameswari

Kesmas

WHO memperkirakan bahwa setiap tahun lebih dari 9 juta bayi meninggal pada periode perinatal dan hampir semua terjadi di negara berkembang. Kini angka kematian perinatal di Indonesia adalah 24 per 1.000 kelahiran, sekitar 77% merupakan sumbangan kematian neonatal. Tujuan penelitian ini adalah mengetahui faktor-faktor yang berhubungan dengan kejadian kematian perinatal di Indonesia dan memperkirakan program intervensi yang paling berperan dan menurunkannya. Studi ini menggunakan sumber data sekunder Survei Demografi Kesehatan Indonesia (SDKI) tahun 2002-2003. Desain penelitian yang digunakan adalah potong lintang (cross sectional). Hasil menemukan variabel yang berhubungan terhadap kematian perinatal di Indonesia selama periode 1997-2003 adalah jarak kelahiran; komplikasi …

A Cohort Study Of Reproductive And Hormonal Factors And Renal Cell Cancer Risk In Women, Gc Kabat, Stephanie A. Navarro Silvera, Ab Miller, Te Rohan

Department of Public Health Scholarship and Creative Works

We examined the association of reproductive and hormonal factors with renal cell cancer risk in a cohort study of 89 835 Canadian women. Compared with nulliparous women, parous women were at increased risk (hazard ratio (HR) 1.78, 95% confidence interval (CI) 1.02–3.09), and there was a significant gradient of risk with increasing levels of parity: relative to nulliparous women, women who had X5 pregnancies lasting 4 months or more had a 2.4-fold risk (HR 1⁄4 2.41, 95% CI 1⁄4 1.27–4.59, P for trend 0.01). Ever use of oral contraceptives was associated with a modest reduction in risk. No associations were …

Nevada Institute For Children's Research And Policy Legislative Bills-2007 Session, The Nevada Institute For Children’S Research And Policy

Nevada Institute for Children's Research and Policy Reports

Legislative Bills-2007 Session for Nevada Institute for Children's Research and Policy.

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

Disclosure Of Maternal Hiv Status To Children: To Tell Or Not To Tell . . . That Is The Question, Tanya L. Tompkins

Faculty Publications

HIV-infected mothers face the challenging decision of whether to disclose their serostatus to their children. From the perspective of both mother and child, we explored the process of disclosure, providing descriptive information and examining the relationships among disclosure, demographic variables, and child adjustment. Participants were 23 mothers and one of their noninfected children (9 to 16 years of age). Sixty-one percent of mothers disclosed. Consistent with previous research, disclosure was not related to child functioning. However, children sworn to secrecy demonstrated lower social competence and more externalizing problems. Differential disclosure, which occurred in one-third of the families, was associated with …

Parentification And Maternal Hiv Infection: Beneficial Role Or Pathological Burden?, Tanya L. Tompkins

Faculty Publications

Parentification, along with parenting and child adjustment were examined in 23 9-through 16-year-old youth from families affected by maternal HIV infection and 20 same-age peers whose mothers were not infected. Children whose mothers were HIV-positive reported to more often engage in parental role behaviors, relative to children of HIV-negative mothers. This difference remained even after controlling for the effects of current drug use, number of adults per child in the household, and marital status. Findings revealed a beneficial relationship between parentification and both child adjustment and parenting, particularly among families affected by maternal HIV infection. When relationships were examined separately …

Examining Smoking And Cessation During Pregnancy Among An Appalachian Sample: A Preliminary View, Lesley Cottrell, Mark Gibson, Carole Harris, Alia Rai, Sabera Sobhan, Traci Berry, Bonita Stanton

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Several transitions that a woman experiences prenatally may influence her desire or ability to discontinue smoking. This study explores the role of smoking for young, Appalachian, nulliparous pregnant women and their plans for smoking during their pregnancies.

Results

The reports of women and their male partners were taken from baseline interviews conducted during the first trimester of pregnancy. Cigarette smoking appeared to be more than an isolated addictive activity; rather, smoking was interwoven in women's social and personal realms, often changing as their perceptions of self changed. Women and their partners who continued to smoke appeared to be …

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, …

Exploring The Barriers To Accessing Care And Treatment For Hiv-Infected Children In India: A Diagnostic Study, Avina Sarna, Jaleel Ahmad, Glory Alexander, Vaishali Sharma Mahendra, Ashok Rau, Arjun Singh, Naomi Rutenberg

HIV and AIDS

Each year 27 million births take place in India. A conservative estimate of HIV prevalence of 1 percent among antenatal women translates to about 80,000 HIV-infected children being born annually. The latest figures from the National AIDS Control Organisation show that there are about 5,600 documented HIV-positive children (0–14 years), but a very small number are receiving antiretroviral therapy. The Population Council and partners conducted a qualitative study in three high-prevalence states of India to explore the facilitators and barriers to accessing care for HIV-positive children and assessed the current level of adherence to ART among children receiving treatment. A …

The Status Of Childhood Lead Poisoning And Prevention In Nevada, Usa, Anne Rothweiler, Elena E. Cabb, Shawn Gerstenberger

Environmental & Global Health Faculty Research

One of the first steps in addressing the problem of childhood lead poisoning is to identify the possible sources of exposure in specific communities and target high-risk populations with appropriate interventions. Due to several factors, such as lack of funding and lack of blood lead reporting, little information exists regarding the occurrence of childhood lead poisoning and the prevalence of potential exposure sources in the state of Nevada. Following the recent establishment of a Nevada-based Lead Poisoning Program, we compiled the most current information available on Nevadans, and use this knowledge to suggest future research objectives and outreach activities for …

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, …

Situation Analysis Of The Sexual And Reproductive Health And Hiv Risks And Prevention Needs Of Older Orphaned And Vulnerable Children In Nyanza Province, Kenya, Milka Juma, Ian Askew, Alan Ferguson

Reproductive Health

The increasing number of children in Kenya who are orphaned or made vulnerable (OVC) from HIV/AIDS and other factors calls for a holistic understanding of their situation so that effective programs to address their needs can be designed. This is especially important for those areas hardest hit by the HIV/AIDS pandemic, such as Nyanza Province. Little is known about the vulnerabilities of older orphans to risky sexual behavior, and whether they are more vulnerable than nonorphans. The Department of Children’s Services has initiated a cash transfer program to households taking care of OVC. The main objective is to provide a …

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. …

Kenya: Multisectoral Engagement Increases Support For Adolescent Reproductive Health, Frontiers In Reproductive Health

Reproductive Health

In 1999, FRONTIERS launched the Kenya Adolescent Reproductive Health Project (KARHP), testing a multisectoral approach to improving young people’s reproductive health knowledge and behavior at community, school, and health-facility levels in two pilot districts in the Western Province. The intervention involved three key government ministries—Education, Science and Technology, Health, and Gender, Sports, Culture, and Social Services—with input from community leaders, parents, and youth. Positive findings from the study convinced the three ministries and USAID to institutionalize and scale up selected elements from the pilot project. In 2003, FRONTIERS and PATH began providing technical assistance aimed at mainstreaming and expanding cost-effective …

The Experience Of Married Adolescent Girls In Northern Nigeria, Annabel Erulkar, Mairo Bello

Poverty, Gender, and Youth

Programs for young people in sub-Saharan Africa have been directed largely toward unmarried adolescents, neglecting the fact that a large proportion of adolescents—especially girls—are married in some settings. Early marriage is a common feature of girls’ adolescence in Northern Nigeria, yet few programs are in place to support this sizable and vulnerable group. To suggest directions for future programming, Adolescent Health and Information Projects (AHIP) and the Population Council examined the lives of married and unmarried girls in two geopolitical regions of Nigeria, North West and North East. The study, as described in this report, consisted of secondary analysis of …

Changing Transitions To Adulthood In Vietnam's Remote Northern Uplands: A Focus On Ethnic Minority Youth And Their Families [Vietnamese], Bussarawan Teerawichitchainan, Hac Van Vinh, Nguyen Thi Phuong Lan

Poverty, Gender, and Youth

Ethnic minorities, who tend to live in remote mountainous areas, account for 15 percent of Vietnam’s 84 million total population and, according to a recent estimate, 61 percent of them are poor. Evidence suggests that despite recent efforts by the Government of Vietnam to promote poverty reduction in remote areas, a majority of ethnic minorities have not yet experienced positive change, contrary to their Kinh (ethnic Vietnamese) neighbors who have enjoyed substantial improvement in living standards. To identify program interventions that promote healthy human development and, in turn, positively affect Vietnam’s economic growth, it is crucial to have a comprehensive …

The Role Of Schools In Promoting Sexual And Reproductive Health Among Adolescents In Developing Countries, Cynthia B. Lloyd

Poverty, Gender, and Youth

This Population Council working paper reviews the state of knowledge about relationships between schooling and adolescent reproductive health. With the spread of mass schooling and the growing share of adolescents who attend school, the opportunities for synergies between health and education policies and programs are growing. Data on cross-country variations in health conditions on the one hand, and variations in attendance and attainment patterns and school systems on the other hand, provide a framework for assessing alternative approaches to the promotion of adolescent sexual and reproductive health in different contexts. Disappointing findings from recent school-based reproductive health interventions in poor …

Girls' Adolescence In Burkina Faso: A Pivot Point For Social Change, Martha Brady, Lydia Saloucou, Erica Chong

Poverty, Gender, and Youth

As closer attention is paid to the lives of adolescents in sub-Saharan Africa, girls are found to be clearly disadvantaged, compared with their male counterparts. Burkinabé girls are frequently married at a young age, and more than one-third of married girls find themselves in polygamous unions as second or third wives, married to much older men. Understanding and recognizing girls’ realities is an important first step in planning appropriate and meaningful interventions for them. Girls who are unmarried, “promised,” engaged, or married face different constraints and merit different program approaches. This report by the Population Council aims to fill gaps …