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Articles 1 - 30 of 80
Full-Text Articles in Maternal and Child Health
The Real Toy Story: The San Francisco Board Of Supervisors Healthy Food Incentives Ordinance, Cortney Price
The Real Toy Story: The San Francisco Board Of Supervisors Healthy Food Incentives Ordinance, Cortney Price
Journal of Food Law & Policy
Obesity among children in the United States has tripled over the last thirty years. Incidentally, the world's largest fast food restaurant, McDonald's, first introduced its children's Happy Meal thirty-two years ago. Shortly thereafter, the first Disney inspired toy found its way into Happy Meals and the hearts of the "billions and billions served." Although the iconic Happy Meal and accompanying toy have become "a staple of Americana akin to baseball and apple pie," the continued existence of the practice is being threatened in light of the powerful influence toys have on children's food choices, thus contributing to the current obesity …
Adverse Maternal Outcomes For Women With Different Health Insurance Statuses In Nevada, Jay J. Shen, Hong Wei
Adverse Maternal Outcomes For Women With Different Health Insurance Statuses In Nevada, Jay J. Shen, Hong Wei
Nevada Journal of Public Health
Objective. Nevada women with unfavorable health insurance status may face greater barriers than women in the rest of the nation, since the development of healthcare infrastructure in Nevada is running behind population growth. This study examines the relationship between health insurance status and adverse maternal outcomes in Nevada.
Methods. Hospital discharge information of 33,149 women aged 13 or older who delivered in 2004 was abstracted from the 2004 State Inpatient Data for Nevada. A total of 13 measures of complications associated with pregnancy were identified, including preterm labor, hypertensive disorders of pregnancy, gestational diabetes, ante-partum hemorrhage, membrane disorders, cesarean section, …
Sexual And Reproductive Health Care Access And Utilization By Mexican Immigrant Women In New York City – A Descriptive Study, Gabriela Betancourt
Sexual And Reproductive Health Care Access And Utilization By Mexican Immigrant Women In New York City – A Descriptive Study, Gabriela Betancourt
Center for Latin American, Caribbean, and Latino Studies
Introduction: This study examines reproductive health care access and utilization by Mexicans in New York City.
Methods: This report uses data collected by Planned Parenthood of New York City (PPNYC) as part of a larger sexual and reproductive health (SRH) needs assessment. We analyzed various demographic factors and barriers to describe SRH access and utilization of services among Mexican immigrant women residing in New York City (NYC). We purposely sampled 151 adult women seeking assistance from the Mexican Consulate of New York City and other community-based organizations (CBOs). Women choosing to participate were administered an anonymous survey. Data collected included …
Blood Lead Levels In Nevada Children, Arthur F. Di Salvo, Terry R. Hall
Blood Lead Levels In Nevada Children, Arthur F. Di Salvo, Terry R. Hall
Nevada Journal of Public Health
The purpose of this study was to assess the prevalence of plumbism in children one to six years of age in Nevada. During a four-year period from 1992 – 1996, 10,700 children were screened for evidence of blood lead intoxication. The capillary specimens were analyzed by atomic absorption spectrometry. All children with a lead level => 10 ug/L were retested using venous blood. Ninety three percent of the children had blood lead levels < 10 µg/dL
Adverse Maternal Outcomes In Nevada: Does Asthma Matter?, Jay J. Shen, Hong Wei, Robin Mukalian
Adverse Maternal Outcomes In Nevada: Does Asthma Matter?, Jay J. Shen, Hong Wei, Robin Mukalian
Nevada Journal of Public Health
Objective. Asthma is a common clinical complication of pregnancy and women with asthma are at greater risk of having complications. This study compared adverse maternal outcomes between women with asthma and women without asthma in Nevada.
Methods. A total of 64,664 hospital discharges of delivery were abstracted from the Nevada 2003-2004 hospital discharges and thirteen adverse maternal outcomes were examined. Logistic regression was applied to compare the maternal outcomes between women with and without asthma.
Results. Women with asthma were more likely to have pre-eclampsia (OR [CI] 1.73 [1.13, 2.65]), transient hypertension of pregnancy (OR [CI] 1.76 [1.11, 2.78]), pregnancy-induced …
Analysis Of Lead Levels In Deciduous Teeth From Children In Clark County, Nevada., Kristin Murphy, Jennifer Berger-Ritchie, Shawn L. Gerstenberger, Amol B. Amin, Jason K. Nitta, Frederick G. More, Jeanne A. Hibler, Karl Kingsley
Analysis Of Lead Levels In Deciduous Teeth From Children In Clark County, Nevada., Kristin Murphy, Jennifer Berger-Ritchie, Shawn L. Gerstenberger, Amol B. Amin, Jason K. Nitta, Frederick G. More, Jeanne A. Hibler, Karl Kingsley
Nevada Journal of Public Health
Background: Elevated blood lead levels (EBLL) are declining in the United States, although some population subgroups continue to exhibit significant health disparities. A childhood lead poisoning prevention program was recently started in Nevada, and many efforts have been made to support this program and increase the screening rates.
Methods: To expand the potential pool of children screened for EBLLs, a pilot study was performed to evaluate lead concentrations in extracted deciduous teeth using Graphic Furnace Atomic Absorption Spectrometry (GFAAS), Inductively Coupled Plasma Mass Spectrometry (ICP-MS), and X-Ray Fluorescence (XRF) analysis.
Results: Lead concentrations as determined by GFAAS and ICP-MS were …
Child Maltreatment Outpatient Visits To Kentucky Non-Federal Acute Care Hospitals, 2008-2010, Marjorie Stanek, Michael Singleton, Svetla Slavova, Terry Bunn
Child Maltreatment Outpatient Visits To Kentucky Non-Federal Acute Care Hospitals, 2008-2010, Marjorie Stanek, Michael Singleton, Svetla Slavova, Terry Bunn
Kentucky Injury Prevention and Research Center Special Report
No abstract provided.
Mongolian Women's Voices: A Case Study On Maternal Healthcare, Pregnancy, And Birth In Ulaanbaatar's Public Hospitals, Amelia Olmsted
Mongolian Women's Voices: A Case Study On Maternal Healthcare, Pregnancy, And Birth In Ulaanbaatar's Public Hospitals, Amelia Olmsted
Independent Study Project (ISP) Collection
Mongolia is a country undergoing an incredible amount of change. Last year, in 2011, they had the fastest growing economy in the world, with a 17.2% increase in their GDP, according to the World Bank. A mere 22 years ago, Mongolia was a communist country, and today they are a parliamentary democracy. The country has opened itself up to the rest of the world and a free market economy, and experienced a very drastic shift in this direction in the early 1990's. Many Mongolians will tell you that the mindset of Mongolia's citizens has made a drastic shift since communism …
Los Factores Sociales Que Influyen En El Embarazo Y En El Uso De Anticonceptivos De Adolescentes En El Barrio 25 De Mayo, Maipú, Mendoza., Isabel Odean
Independent Study Project (ISP) Collection
Background: Adolescent pregnancy is a common phenomenon among those living in poverty. Adolescent pregnancy is influenced by many social and cultural factors, leading to lack of use of contraceptives. This study took place in the neighborhood 25 de Mayo, in the city of Maipú, Mendoza in Argentina. This community is mostly composed of people with low incomes and limited education. Socioeconomic and the attitudes toward teenage pregnancy, as well as the use of contraceptives by adolescents, are distinct from those in wealthier better educated groups. This neighborhood is approximately 10,000 people, the majority of whom are women. Most of the …
Is It Really Just All About Sex And Money? A Case Study Of Teenage Motherhood In The Village Of Kwaximba In The Valley Of A 1,000 Hills, Margaret Nelson
Is It Really Just All About Sex And Money? A Case Study Of Teenage Motherhood In The Village Of Kwaximba In The Valley Of A 1,000 Hills, Margaret Nelson
Independent Study Project (ISP) Collection
The aim of this learnership at the Valley Trust was to gain insight into why teenage girls in the Valley of the 1,000 Hills fall pregnant and what is the cost of early motherhood on the future of young women. Previous research of the province KwaZulu-Natal has revealed that teenage pregnancies are a large problem in school districts and restricting the future academic pursuits of teenage mothers. The learner worked alongside the Valley Trust in coordination with their outreach programs in the local villages of the Valley of a 1,000 Hills to learn fundamental and underlying reasons behind teenage pregnancy …
Bright Futures As-Is Assessment: How Child-Serving Practices, Health Systems, And The State Of Maine Use And Exchange Specific Clinical Data Related To Child Health Quality Measures, Kyra Chamberlain Ms, Rn, Martha Elbaum-Williamson Mpa, Jonathan Ives Mpm, Csm, Jin Liao M.Eng
Bright Futures As-Is Assessment: How Child-Serving Practices, Health Systems, And The State Of Maine Use And Exchange Specific Clinical Data Related To Child Health Quality Measures, Kyra Chamberlain Ms, Rn, Martha Elbaum-Williamson Mpa, Jonathan Ives Mpm, Csm, Jin Liao M.Eng
Population Health & Health Policy
The purpose of the As Is assessment is to provide a description of Maine’s current HIT environment specifically pertaining to how EPSDT and other clinical data are entered, used, and exchanged electronically through information systems at pediatric practices, health systems, the State of Maine, and HIN. This information will inform plans currently under development by IHOC for electronic data exchange and child health measure calculation.
Effect Of Food Security And Federal Food Assistance Participation On Household Availability And Recorded Preschool Child Consumption Of Sugar Sweetened Beverages And 100% Fruit Juice, Katherine A. Yarbrough
Effect Of Food Security And Federal Food Assistance Participation On Household Availability And Recorded Preschool Child Consumption Of Sugar Sweetened Beverages And 100% Fruit Juice, Katherine A. Yarbrough
Master's Theses
Sugar sweetened beverage consumption is on the rise in the United States, particularly among children. However, the impact of household food security and federal food assistance participation on beverage habits has not been extensively analyzed. This paper sought to fill the current gap in literature on household beverage availability and recorded preschool child consumption of sugar sweetened beverages (SSB) and 100% fruit juice based on food security levels and status of federal food assistance participation. For this thesis, SSB are beverages that have added sugar and include fruit drinks, sodas, sports drinks, syrups, flavored milks, and teas. Baseline data from …
2011 Annual Report Of Child Deaths In Clark County, Nevada, Nevada Institute For Children’S Research And Policy, Tara Phebus
2011 Annual Report Of Child Deaths In Clark County, Nevada, Nevada Institute For Children’S Research And Policy, Tara Phebus
Nevada Institute for Children's Research and Policy Reports
The primary goal of all Child Death Review Teams is to prevent future child deaths. The child death review process enables jurisdictions to come together in a collaborative, multidisciplinary forum to openly discuss detailed circumstances in an effort to gain a better understanding of child deaths. The team provides a venue for representatives from a variety of both public and private agencies as well as community organizations to share information in a confidential and non-threatening environment. The National Center for Child Death Review (hereinafter, National Center), which is supported by the Maternal and Child Health Bureau of the U.S. Department …
Ethiopia: Tragedy We Can Prevent, Hudda Ibrahim
Ethiopia: Tragedy We Can Prevent, Hudda Ibrahim
English Student Work
No abstract provided.
African American And Non-Hispanic White Births In Enhanced Prenatal Care Programs And Wic, Monica Cain
African American And Non-Hispanic White Births In Enhanced Prenatal Care Programs And Wic, Monica Cain
Journal of Health Disparities Research and Practice
North Carolina uses Maternity Care Coordination (MCC), an enhanced prenatal care program, to improve birth outcomes for high risk women. The WIC program provides similar services to achieve the same goal. Women in North Carolina Medicaid can choose to participate in either, both, or neither the MCC and WIC programs. The study compares the percentages of low birth weight (LBW)—less than 2500 grams—births and maternal risk characteristics of women: (1) participating in the MCC program only, (2) participating in WIC only, or (3) participating in both programs, to those women who receive conventional Medicaid prenatal care. The analysis is further …
Post-Abortion Care Family Planning Use In Pakistan, Syed Khurram Azmat, Waqas Hameed, Muhammad Ishaque, Ghulam Mustafa, Aftab Ahmed
Post-Abortion Care Family Planning Use In Pakistan, Syed Khurram Azmat, Waqas Hameed, Muhammad Ishaque, Ghulam Mustafa, Aftab Ahmed
Community Health Sciences
Introduction: The stagnated CPR and high unmet need for contraception lead to approximately 890,000 induced abortions every year in Pakistan. A fairly recent study from Pakistan also revealed that around 40% of abortions are performed by unskilled workers in backstreet clinics. Considering these grave statistics, it should not come as surprise that unwanted pregnancies are the leading cause of induced abortions in Pakistan. Despite country's inferior situation, there is no data available in Pakistan that unveils the much needed information pertaining to post-abortion care family planning (PAC) use. Thus, this paper attempts to document socio-demographic profile seeking post-abortion care clients; …
Delivering Quality Care: The Roles And Future Of Midwives In Southern California, Abigail Jones
Delivering Quality Care: The Roles And Future Of Midwives In Southern California, Abigail Jones
Scripps Senior Theses
The United States is ranked 27th in the world for maternal mortality, yet spends twice as much on maternity care services as countries with better maternal health indicators. Stuck in a technocratic and physician-dominated maternity care system, the U.S. depends on expensive technologies to control birth out of fear of pain and litigation, costing Americans billions of dollars and depriving women of the opportunity to have a transformative birth experience. Through an analysis of the medicalization of birth and the current biomedical model in birth, in conjunction with open-ended interviews with 5 hospital midwives and 3 homebirth midwives, the …
Evaluation Of A Tobacco Educational Intervention For Pregnant Alaska Native Women, Christi A. Patten, Carrie Enoch, Caroline C. Renner, Karin Larsen, Paul A. Decker, Kari J. Anderson, Caroline Nevak, Ann Glasheen, Kenneth P. Offord, Anne Lanier
Evaluation Of A Tobacco Educational Intervention For Pregnant Alaska Native Women, Christi A. Patten, Carrie Enoch, Caroline C. Renner, Karin Larsen, Paul A. Decker, Kari J. Anderson, Caroline Nevak, Ann Glasheen, Kenneth P. Offord, Anne Lanier
Journal of Health Disparities Research and Practice
Tobacco cessation interventions developed and evaluated for Alaska Native women do not exist. As part of routine clinical care provided at a prenatal visit, a brief tobacco educational intervention for Alaska Native pregnant women (N=100; mean ± SD age = 25.9±6.2 years; mean 6.3± 2.6 months gestation) was piloted at the Y-K Delta Regional Hospital in Bethel, Alaska. This retrospective study reports on the evaluation of this clinical program. The intervention was consistent with the clinical practice guidelines (i.e., 5 A’s – ask, advise, assess, assist, arrange), with an average duration of 20.2 ± 6.8 minutes. The self-reported tobacco abstinence …
Examination Of Racial Disparities In Childhood Asthma Management Practices, Crystal N. Piper, Saundra Glover, Kieth Elder, Jong-Deuk Baek
Examination Of Racial Disparities In Childhood Asthma Management Practices, Crystal N. Piper, Saundra Glover, Kieth Elder, Jong-Deuk Baek
Journal of Health Disparities Research and Practice
Objective: To analyze asthma management plan practices for children with asthma in the United States considering race and other demographic and person-level characteristics.
Methods: Univariate/Bivariate/Multivariate analysis was performed to examine asthma management plan physician recommendations among children in the United States utilizing secondary data analysis of the 2002 and 2003 National Health Interview Survey.
Results: The majority of the study participants reported not having an asthma management plan at (59.00%). In multivariate analysis using SAS callable SUDAAN, Whites were significantly more likely to have an asthma management plan (OR=1.66, p=.0031).
Conclusion: Findings from this study indicate that Black and Hispanic …
Utilizing Community Resources To Reduce The Presence Of Type 2 Diabetes In Rural Youth, Antonia S. Mead, M. C. Nagy, Stephen Nagy
Utilizing Community Resources To Reduce The Presence Of Type 2 Diabetes In Rural Youth, Antonia S. Mead, M. C. Nagy, Stephen Nagy
Journal of Health Disparities Research and Practice
The purpose of this study was to implement a program designed to promote diabetes prevention activities among preadolescents in a rural southern setting using a day camp intervention. Participants in the study were eleven youth from a rural Alabama county who participated in a week-long half-day camp administered by local and community volunteers. Change scores were used to compare pre- to post- to follow-up measures for camp participant responses. Program results consistently demonstrated that the day camp was theoretically sound and that program activities positively impacted behavioral antecedents. This study demonstrated the feasibility of conducting a diabetes prevention day camp …
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
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 …
The Antecedents, Process, And Consequences Of Female Sterilization For Low-Income Women In Mumbai, Marie A. Brault
The Antecedents, Process, And Consequences Of Female Sterilization For Low-Income Women In Mumbai, Marie A. Brault
Master's Theses
Surgical sterilization is the primary method of family planning among low-income women in India; the result of limited knowledge and poor access to family planning alternatives. To understand the dynamics of sterilization, 37 in-depth interviews were conducted with sterilized women from the study community, as well as key informant interviews with community men, providers and government officials. The results indicate that sterilization decisions are made after exceeding ideal family size, that the procedures for sterilization frequently do not follow official protocol, but that for the most part women are highly positive about being free of the risk of unwanted conception.
Elementary School Based Health Centers As Providers Of School Entry Health Exams: Do They Meet The Standards?, Roberta Bavin
Elementary School Based Health Centers As Providers Of School Entry Health Exams: Do They Meet The Standards?, Roberta Bavin
UNLV Theses, Dissertations, Professional Papers, and Capstones
The health of today's children is crucial for the future of our society. There are many children without access to healthcare in these turbulent economic times; times that are increasingly uncertain as society maneuvers its way through the maze of healthcare reform. School based health centers (SBHCs) provide a safety net for children needing basic healthcare who are otherwise underserved. School entry health examinations (SEHE) are legal requirements in many states, and are a proven method for identifying health conditions early enough in a child's life that they can be corrected. Treating identified health conditions facilitates academic success for children, …
Clinical Utility Of Folate-Containing Oral Contraceptives., Zohra S Lassi, Zulfiqar Ahmed Bhutta
Clinical Utility Of Folate-Containing Oral Contraceptives., Zohra S Lassi, Zulfiqar Ahmed Bhutta
Woman and Child Health
Folate is a generic term for a water-soluble B-complex vitamin which plays an important role in protein synthesis and metabolism and other processes related to cell multiplication and tissue growth. Pregnant and lactating women are at increased risk of folic acid deficiency because generally their dietary folate is insufficient to meet their physiological requirements and the metabolic demands of the growing fetus. The evidence pertaining to the reduction of the risk of neural tube defects (NTDs) due to folate is so compelling that supplementation with 400 mug of folic acid to all women trying to conceive until 12 weeks of …
Global Impacts Of Media On Tobacco Use Among Adolescents: A Comparative Analysis Of The United States And China, Katherine Theresa Lesyna
Global Impacts Of Media On Tobacco Use Among Adolescents: A Comparative Analysis Of The United States And China, Katherine Theresa Lesyna
Scripps Senior Theses
Tobacco use is responsible for five million deaths annually and is one of the leading causes of preventable death worldwide. Many smokers initiate smoking behavior during adolescence. Adolescent smoking rates have been on the rise and there are a variety of different factors that contribute to the initiation of smoking behavior. While the World Health Organization (WHO) and the National Cancer Institute (NCI) have endorsed the claim that smoking in movies increases adolescents’ risk of initiating smoking, few studies have examined the impact of media on adolescent smoking in China following the expansion of transnational tobacco companies. The aim of …
Family Home Visitors: Increasing Minority Women’S Access To Health Services, Mechthild Meyer, Alma R. Estable, Lynne Maclean, Wendy E. Peterson
Family Home Visitors: Increasing Minority Women’S Access To Health Services, Mechthild Meyer, Alma R. Estable, Lynne Maclean, Wendy E. Peterson
Journal of Health Disparities Research and Practice
The article describes how service access barriers (language, trust) were addressed at different levels (organization, service provider, community) by involving Family Home Visitors to support Nurse Practitioners in providing pre- and postnatal services to linguistic minority women in Ontario. The investigators undertook a secondary analysis of 18 semi-structured interviews with health unit informants, Nurse Practitioners, program users, and community leaders, including Family Home Visitors. Health units facilitated collaboration between two programs aimed at serving mothers with young children, resulting in both programs using Family Home Visitors. They enhanced minority women’s trust in Nurse Practitioner services by providing interpretation, outreach and …
A Social Controversy: Autism Spectrum Disorder's Correlation To The Measles-Mumps-Rubella Vaccination, Lindsay A. Frye
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 …
Pap Test Follow-Up Pattern Among American Indian Women In Arizona, Merrill Eisenberg, Kathryn Coe, Charlton Wilson, Kathleen Evans, Elizabeth Brewer
Pap Test Follow-Up Pattern Among American Indian Women In Arizona, Merrill Eisenberg, Kathryn Coe, Charlton Wilson, Kathleen Evans, Elizabeth Brewer
Journal of Health Disparities Research and Practice
Objective: To quantify the loss to follow-up rate after abnormal Pap test results at the Phoenix Indian Medical Center, an Indian Health Service regional facility, and identify barriers to follow-up from the patients’ point of view.
Materials and Methods: Patient records were used to identify women who had abnormal Pap tests in 2002 and to document the status of their follow-up care. Women who had no clinical record of follow-up were contacted by telephone to arrange a follow-up appointment and to request participation in a structured qualitative interview to identify barriers to follow-up at the individual, family, community, and health …
Lo Personal Es Político: La Lucha Por La Legalización Del Aborto En Chile, A Través De La Organización Feminista, Católicas Por El Derecho A Decidir, Gavin Odabashian
Lo Personal Es Político: La Lucha Por La Legalización Del Aborto En Chile, A Través De La Organización Feminista, Católicas Por El Derecho A Decidir, Gavin Odabashian
Independent Study Project (ISP) Collection
This paper investigates the work of a small collective of women—Católicas por el Derecho a Decidir—and the practice of their activism in Valparaíso, Chile. I focus on the ways in which these women are strategically mobilizing as an organization to fight for justice for women in Chile—more specifically, for gender equality, access to reproductive rights, and the legalization of abortion in all cases. I examine the history of the organization, its form and structure, the projects and campaigns they are currently working on, the individual experiences of the women working within the organization, their perspectives on their work, …
Un Compromiso Al Parto Culturalmente Sensible: Una Evaluación De La Interculturalidad En Salud Reproductiva En El Norte De Chile, Kalin J. Gregory-Davis
Un Compromiso Al Parto Culturalmente Sensible: Una Evaluación De La Interculturalidad En Salud Reproductiva En El Norte De Chile, Kalin J. Gregory-Davis
Independent Study Project (ISP) Collection
Este investigación observa, explora, y describe la interculturalidad en la salud reproductiva en la región de Arica y Parinacota en el norte de Chile durante el mes de mayo, 2012. A causa de la diversidad étnica de la región y las diferencias en las tradiciones y creencias acerca del parto aymara, natural y medicalizado, existe una necesidad de atención alternativa en el sistema de salud. El estudio describe la atención alternativa ofrecida a las mujeres aymara durante el embarazo y el parto. Empleando las perspectivas y las percepciones culturales de parteras aymaras, profesionales médicos occidentales y mujeres involucradas, el estudio …