Maternal and Child Health Commons^™

Delivering Water, Sanitation And Hygiene Interventions To Women And Children In Conflict Settings: A Systematic Review, Daina Als, Sarah Meteke, Marianne Stefopulos, Michelle F. Gaffey, Mahdis Kamali, Mariella Munyuzangabo, Shailja Shah, Reena P. Jain, Amruta Radhakrishnan, Fahad J. Siddiqui, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Access to safe water and sanitation facilities and the adoption of effective hygiene practices are fundamental to reducing maternal and child morbidity and mortality globally. In armed conflict settings, inadequate water, sanitation and hygiene (WASH) infrastructure poses major health risks for women and children. This review aimed to synthesise the existing information on WASH interventions being delivered to women and children in conflict settings in low-income and middle-income countries (LMICs) and to identify the personnel, sites and platforms being used to deliver such interventions.
Methods: We conducted a systematic search for publications indexed in four databases, and grey literature …

Delivery Of Sexual And Reproductive Health Interventions In Conflict Settings: A Systematic Review, Mariella Munyuzangabo, Dina Sami Khalifa, Michelle F. Gaffey, Mahdis Kamali, Fahad J. Siddiqui, Sarah Metek, Shailja Shah, Reena P. Jain, Daina Als, Amruta Radhakrishnan, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: It is essential to provide comprehensive sexual and reproductive health (SRH) interventions to women affected by armed conflict, but there is a lack of evidence on effective approaches to delivering such interventions in conflict settings. This review synthesised the available literature on SRH intervention delivery in conflict settings to inform potential priorities for further research and additional guidance development.
Methods: We searched MEDLINE, Embase, CINAHL and PsycINFO databases using terms related to conflict, women and children, and SRH. We searched websites of 10 humanitarian organisations for relevant grey literature. Publications reporting on conflict-affected populations in low-income and middle-income countries …

Speaking Volumes: The Failure Of American Courts To Address The Underlying Themes Of Silence And Patriarchy Within The Civil Order Of Protection Process In Davenport, Iowa, Catherine Priebe

Sociology: Student Scholarship & Creative Works

Domestic abuse is a pervasive issue within the United States. Approximately three women will be murdered by an intimate partner every day and around half of all women will experience psychological abuse by an intimate partner in their lifetime. As such, it is important to have legal avenues that survivors can pursue in order to ensure safety for themselves and their children. There are many obstacles to obtaining a civil order of protection despite it being the most common legal option survivors choose to pursue. Survivors must take on the burden of proof and hire their own attorney if they …

Impact Of Childhood Vaccinations Suspended Due To Covid-19, Karina I. Figueroa

2020 Symposium Posters

Due to the COVID-19 outbreak of 2020, a public health issue has been created that has the potential to significantly affect our view on society. Among the variety of preventative tactics to slow the spread of infection, there has been a suspension of childhood vaccination across the globe including among developing countries. The World Health Organization (WHO) has announced that governments suspend preventive vaccination programs briefly during the pandemic as of March 26th (Ray, 2020). As a result of this, there has been an impact on children's health and an increase in mortality rates. The purpose of this research paper …

Safe Consumption Sites And The Perverse Dynamics Of Federalism In The Aftermath Of The War On Drugs, Deborah Ahrens

Dickinson Law Review (2017-Present)

In this Article, I explore the complicated regulatory and federalism issues posed by creating safe consumption sites for drug users—an effort which would regulate drugs through use of a public health paradigm. This Article details the difficulties that localities pursuing such sites and other non-criminal-law responses have faced as a result of both federal and state interference. It contrasts those difficulties with the carte blanche local and state officials typically receive from federal regulators when creatively adopting new punitive policies to combat drugs. In so doing, this Article identifies systemic asymmetries of federalism that threaten drug policy reform. While traditional …

Delivering Non-Communicable Disease Interventions To Women And Children In Conflict Settings: A Systematic Review, Shailja Shah, Mariella Munyuzangabo, Michelle F. Gaffey, Mahdis Kamali, Reena P. Jain, Daina Als, Sarah Meteke, Amruta Radhakrishnan, Fahad J. Siddiqui, Anushka Ataullahjan, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Non-communicable diseases (NCDs) are the leading cause of death worldwide. In the context of conflict settings, population displacement, disrupted treatment, infrastructure damage and other factors impose serious NCD intervention delivery challenges, but relatively little attention has been paid to addressing these challenges. Here we synthesise the available indexed and grey literature reporting on the delivery of NCD interventions to conflict-affected women and children in low- and middle-income countries (LMICs).
Methods: A systematic search in MEDLINE, Embase, CINAHL and PsycINFO databases for indexed articles published between 1 January 1990 and 31 March 2018 was conducted, and publications reporting on NCD …

The Experience Of Intimate Partner Violence Among Pregnant Women Seeking Treatment For Opioid Use Disorder, Julia Dewey, Diane Abatemarco, Phd, Msw

Phase 1

Introduction: Intimate partner violence (IPV) is a major health issue among those with substance use disorder. A history of partner violence is associated with increased health problems and less improvement in treatment. The perinatal period is a time of increased risk of IPV for women, as well as a key opportunity for opioid use disorder treatment intervention. The purpose of this study is to characterize the experience of partner violence and evaluate the typology of sequelae associated with it in a population of pregnant women seeking medication assisted treatment for opioid use disorder.

Methods: The population of interest in this …

The Effects Of Centering Pregnancy On Attitudes Towards Breastfeeding Among Women With Opioid Use Disorder, Francesca Mancuso, Vanessa Short, Phd, Mph

Phase 1

Introduction: Breastfeeding has been found to decrease severity of neonatal abstinence syndrome (NAS), however, breastfeeding rates among women with opioid use disorder (OUD) are significantly lower than national averages. CenteringPregnancy, a group prenatal care model, increases exposure to education regarding breastfeeding, making it more likely that patients breastfeed in traditional populations.

Objective: This project’s purpose was to identify and understand current infant feeding attitudes among mothers with OUD and explore whether participation in the CenteringPregnancy “Breastfeeding Session” positively impacted knowledge and attitudes towards breastfeeding.

Methods: Data were collected from 12 women in treatment for OUD who participated in CenteringPregnancy. A …

Identifying Protective Factors In Response To Discriminatory Experiences Among Pregnant African American Woman, Effie Mathew, Krys Foster, Md

Phase 1

Adverse maternal-fetal health outcomes, such as low birth weight and preterm delivery, are disproportionately more likely among African-Americans than Non-Hispanic Whites. Experiences of discrimination have been hypothesized as a contributing factor to the large discrepancies in maternal-fetal health outcomes. It is well understood that with increased levels of self-reported discrimination, there are lower ratings of physical and mental health, and higher reporting rates of depressive symptoms; this relationship is stronger in women. In addition to this, skin tone has long been a marker for social class and opportunity, but research on skin tone as a risk factor for African Americans …

An Environmental Assessment Of Barriers To Hpv Vaccination In Lira, Uganda, Mary Ryan, Amy Leader, Phd

Phase 1

Introduction: Vaccination against HPV is a global concern, given that cervical cancer is the most common cancer among women in developing countries, such as Uganda. Uganda has launched a national program to vaccinate girls 9-13 with Gardasil^â for HPV prevention, yet areas like Lira in northern Uganda are well below the 80% coverage goal. While there is infrastructure at a national level to vaccinate girls against HPV, this project aimed to assess barriers to vaccination at a local level.

Methods: Semi-structured interviews with individuals in Lira, providers at Ayira Health Services, and a stakeholder at the Uganda Ministry of …

A Needs Assessment Of Screening Of Non-Communicable Diseases In Prenatal Care At Chuk And Muhima District Hospital, Vaishali Mehta, Ilana Porges, Kaitlin Demarest, Alex Rugamba, Kelly Kaneza, Magnifique Irakoze, Md

Phase 1

Introduction: There has been a recent trend of women experiencing delays in management for high-risk pregnancies in Kigali, Rwanda. Physicians at the University Teaching Hospital of Kigali (CHUK) have observed a high incidence of women receiving obstetric care that were not screened appropriately. This points to an inconsistent screening method for non-communicable diseases (NCDs) prior to delivery and lack of streamlined care. The objective of this study is to assess the need for more robust screening of maternal NCDs.

Methods: This study, between June 2018-19, is a needs-assessment for the screening of NCDs among pregnant women (n=255) at CHUK. It …

The Effect Of Intrapartum Glycemic Control On The Incidence Of Neonatal Hypoglycemia, Signe Caksa, Amanda Roman, Md

Phase 1

Introduction: 1-2% and 6-9% of pregnancies are complicated by type I/II and gestational diabetes mellitus (DM), respectively, leading to increased risk of adverse neonatal outcomes. Women with DM require glucose monitoring and glycemic control at the time of delivery; however, it remains unclear how variations in intrapartum glucose impact neonatal hypoglycemia.

Methods: This is a retrospective cohort study of women with singleton pregnancies, diagnosed with DM, who delivered >36 weeks gestation after attempting induction of labor at Thomas Jefferson University Hospital between 01/01/2017 and 01/01/2018. Intrapartum DM management included hourly capillary glucose (CG) monitoring until delivery, insulin drip with CG …

Analyzing The Attitudes, Beliefs, And Practices Of Breastfeeding Women At Maternity Care Coalition, Angela Heysel, Conor Bradley, Naima Black, Galissa Jones

Phase 1

Introduction: Breastfeeding is essential for health and bonding within the mother-child dyad. Most guidelines, therefore, suggest women continue breastfeeding up to twelve months post-partum. Discrepancies in achieving this exist across zip codes and race in Philadelphia, despite high overall rates of breastfeeding. Our research goal is to understand these discrepancies and the relationship between attitudes and practices of breastfeeding Philadelphian women, in order to target them with breastfeeding resource.

Methods: General population data was collected via an online survey taken by residents of Philadelphia and the surrounding counties, whereas the focus group survey was taken in-person by Maternity Care Coalition …

Examining The Associations Between Addiction Severity And Prior Adverse Childhood Experiences In Pregnant Women Receiving Treatment For Opioid Addiction, Julia Gong, Diane Abatemarco, Phd, Msw

Phase 1

Introduction: Opioid use during pregnancy poses risk to both the mother and fetus, including fetal loss and pre-term birth. Prior research suggests that adverse childhood experiences (ACEs) are a plausible antecedent to opioid abuse. However, there is insufficient understanding of the association between prior ACEs, familial history of substance use, and treatment outcomes in pregnant women receiving treatment for opioid addiction.

Methods: A retrospective chart review will be used to review data from 167 MATER patients who entered treatment between 1997 and 2017. Descriptive statistics will be utilized to characterize the study population. Regression and chi-square analyses will be conducted …

Analyzing The Attitudes, Beliefs, And Practices Of Breastfeeding Women At Maternity Care Coalition, Angela Heysel, Conor Bradley, Naima Black, Galissa Jones

Phase 1

Introduction: It is recommended that women breastfeed for twelve months because breastfeeding is an important part of infant development and maternal bonding. Research shows that despite high overall breastfeeding rates, discrepancies exist in breastfeeding rates across zip codes and race in Philadelphia. The research goal is to develop a community resource to promote breastfeeding in Philadelphia and to understand the impact race and zip code have on breastfeeding attitudes and practices.

Methods: Data was collected from residents of Philadelphia and neighboring counties through an online general population survey and focus group survey. Both surveys addressed demographics and the women’s attitudes …

Perceptions Of Centering Pregnancy At Jefferson’S Maternal Addiction Treatment, Education & Research (Mater) Program, Lindsay Caldarone, Ms, Vanessa Short, Phd, Mph

Phase 1

Introduction: Opioid use and misuse, including during pregnancy, is prevalent across the United States. Many women with opioid use disorder (OUD) face multiple barriers to care, including prenatal care. Group prenatal care, as compared to individual prenatal care, may lead to beneficial outcomes such as reduced odds of preterm birth.

Objective: This study aimed to assess the perceptions of Centering Pregnancy (CP), a group prenatal care program, among women in treatment for OUD.

Methods: The target population included women who participated in the CP program at MATER. Participants (N=6) completed a survey after the last CP session. Survey questions assessed …

Syrian Refugee Mothers In Jordan: Perceived Social Support And Postpartum Depression, Marya Rana

Independent Study Project (ISP) Collection

Many women suffer from postpartum depression; migrant women experience postpartum depression at rates almost triple that of the general population. This study investigated the associations between perceived social support and postpartum depression among Syrian refugee mothers living in Amman, Jordan. Eleven mothers completed a sociodemographic questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), and the Interpersonal Support Evaluation List (ISEL) - Shortened Version. Four of those mothers also participated in individual interviews, and four others were included in a focus group. Multiple recurring themes were identified from the interviews and focus group, including: perceived differences in child and social support in …

A Web-Based Dietary Intervention In Early Pregnancy And Neonatal Outcomes: A Randomized Controlled Trial, Rachel Ak Kennedy, C.M.E. Reynolds, Shona Cawley, E. O'Malley, D.M. Mccartney, M.J. Turner

Articles

Background Maternal nutrition is a determinant of pregnancy outcomes. Few studies have evaluated the potential of online nutrition resources to modify behaviour. This randomized controlled trial aimed to determine whether access to a customized evidence-based nutrition website in pregnancy improved neonatal outcomes.

Methods Women < 18 weeks gestation were recruited at their convenience. The control group received standard care. In addition to standard care, the intervention group received access to an evidence-based nutrition website, customized to the preferences of pregnant women.

Results Of the 250 women, there were no differences in characteristics between the two groups. Of the women, 91.0% reported they make a conscious effort currently to eat a healthy diet. However, only 19.6% met dietary requirements for calcium, 13.2% for iron, 2.7% for folate and 2.3% for iodine. The most popular website section was pregnancy …

Maternal Immune Activation (Mia) In Mice: A Study To Phenotype Asd-Related Communication Behaviors And Analyze Maternal Health Outcomes In The Us, Komalpreet Gulati

Honors Scholar Theses

Core symptoms of Autism Spectrum Disorders (ASD) include deficits in social/communicative behaviors, and repetitive/stereotyped behaviors. Mouse models are a highly established paradigm used to study the phenotypic deficits that result from various inducible genotypic or environmental risk factors for ASD. Previous studies have demonstrated a link between maternal immune activation (MIA) and ASD-like behaviors in mouse models. In this model, the maternal immune system is activated during pregnancy by injecting the viral mimic poly(I:C). The resulting offspring are phenotyped and analyzed with regards to their communicative behaviors.

Previous studies have demonstrated that male pups born to dams with immune activation …

Baby's Best Start: Wic's Role In The Alleviation Of Childhood Obesity, Ashton Hutcheson

Public Health: Student Scholarship & Creative Works

In the past 50 years, obesity prevalence has risen to epidemic-like levels in the United States with an average of 25% of American children being classified as overweight or obese. Prevalence of obesity is significantly increased in socioeconomically disadvantaged income categories. This paper aims to discuss public health preventions/interventions that address childhood obesity such WIC, a supplemental nutrition program for women, infants, and children. It additionally aims to provide broad obesity-related research and begin to suggest preliminary answers to the question of why obesity is so prevalent as well as a brief overview of current treatment options for obesity-related diseases …

Hiv/Aids: Nigeria, Lauren Tropinski

Global Issues in Public Health

Nigeria has one of the largest prevalence rates of HIV infections in Africa. HIV is a communicable disease that is transmitted by bodily fluids through unprotected sex, using contaminated needles, or mother to child. The most affected populations include heterosexuals who have unprotected sex, followed by sex workers, and men who have sex with men. People will experience three stages of HIV before the last stage referred to as AIDS. Rapid diagnostic tests are used to diagnose the disease. There is no cure for HIV/AIDS. However, people with HIV are given antiretrovirals to keep HIV at a low level throughout …

Infant Mortality: Sub-Saharan Africa, Danielle Rae Steffen

Global Issues in Public Health

Like much of the third world, the countries found in Sub-Saharan Africa have a distressingly high infant mortality rate compared to those recorded in places such as the United States and Europe. While there are many factors that play a role in the increased number of infant deaths in this region, lack of access to adequate healthcare for infants and their families is one of the main overarching causes. Although infant mortality rates remain high, there has been significant improvement in infant survival over the last several years which is largely due to the implementation of the Millennium Development Goals …

Supporting Mothers With Mental Illness: Postpartum Mental Health Service Linkage As A Matter Of Public Health And Child Welfare Policy, Jesse Krohn, Msed, Jd, Meredith Matone, Drph, Mhs

Journal of Law and Health

Through our work in youth advocacy as, respectively, legal and public health professionals, we are all too aware of the high levels of health care fragmentation experienced during pregnancy and postpartum by poor, young mothers of color. Meredith Matone’s research highlights the heightened risk of fragmentation for girls with histories of child welfare involvement. For example, she found that 66.7% of young mothers who had resided in out-of-home placements and who had taken antipsychotic medication prior to becoming pregnant failed to fill prescriptions for antipsychotics in their first postpartum year. Put another way, two-thirds of these vulnerable young mothers—a far …

Who's Hungry In San Diego, Alison M. Schurman, Kathy S. James

Doctor of Nursing Practice Final Manuscripts

Objective: Food insecurity (FI) is a lack of access to nutritious food. FI has been linked to multiple preventable diseases from behavioral disorders to asthma to obesity and its sequelae. In San Diego County, 14 percent of families are food insecure. The AAP recommends screening for FI at all well appointments using the two-question FI screening tool. The aim of this project was to implement this tool at a multi-clinic, low income population community health center where ninety-five percent of patients meet qualification for SNAP benefits.

Methods: Stakeholders chose one week to screen all patients presenting to clinic for FI …

Puerto Rico : Zika Virus, Rachel Cybulski

Global Public Health

Puerto Rico has had an epidemic of Zika virus within the past few years. Considering the close distance to America, the U.S. has been up-to-date in stopping the spread of Zika from Puerto Rico to the states. In 2016 particularly, the United States declared Puerto Rico to be in a state of emergency due to the heavy presence of the virus. Although this specific outbreak has been terminated, the likelihood of another such occurrence is high, so it is important to learn about the effects of Zika and ways to prevent the spread. The major result of having the virus …

Continuous Care In Complex Contexts: Access To Health Services For Noncommunicable Diseases Among Syrian Refugee Women In Jordanian Host Communities, Jennifer Ostrowski

Independent Study Project (ISP) Collection

This study examines how, when and where Syrian refugee women living in a host community in central Jordan access health services related to noncommunicable diseases. Noncommunicable diseases are the leading cause of death and disability worldwide, but can be effectively managed through timely treatment. Examining access to care for these diseases in the context of humanitarian emergencies, such as war and displacement, is particularly important because they require continuous care, which may be interrupted during emergencies, and because they can cause acute complications, which may be exacerbated by emergencies (WHO, 2016).

Previous studies indicate a high burden of NCDs among …

Injury-Related Infant Deaths: A State Analysis Of A Public Health, Health Care, Policy Network, Sharla Smith, Xi Zhu, Mary Aitken

Frontiers in Public Health Services and Systems Research

Introduction: This research examines a state-level public health, health care, and policy network focused on efforts to reduce unintentional childhood injuries. The network is composed of 12 organizations: four public health, four health care, and four policy.

Methods: A 23-item survey was administered to the 12 organizations between January and June 2015. Analyses were conducted using HyperResearch and UCInet 6.

Results: More organizations worked together on assessment and planning efforts that identify and quantify the nature of at-risk infants in the community and strategies for reducing injury-related infant deaths. The Injury Prevention Center, the most central organization, interacted most frequently …

Reproductive Rights In Latin America: A Case Study Of Guatemala And Nicaragua, Katherine W. Bogen

Scholarly Undergraduate Research Journal at Clark (SURJ)

A lack of access to contraceptives and legal abortion for women throughout the nations of Nicaragua and Guatemala creates critical health care problems. Moreover, rural and underprivileged women in Guatemala and Nicaragua are facing greater limitations to birth control access, demonstrating a classist aspect in the global struggle for female reproductive rights. Although some efforts have been made over the past half-century to initiate a dialogue on the failure of medical care in these nations to adequately address issues of maternal mortality and reproductive rights, the women's reproductive health movements of Nicaragua and Guatemala have struggled to reach an effective …

The Impact Of Jordanian Health Care Policy On The Maternal And Reproductive Health Care Seeking Behavior Of Syrian Refugee Women, Momina Mazhar

Independent Study Project (ISP) Collection

On November 20, 2014, the Jordanian government rescinded the free health care it had provided to Syrian refugees living in the host community. Now, Syrians must pay the same amount as uninsured Jordanians when seeking health care in facilities run by the Jordanian Ministry of Health. Identified as a vulnerable and disadvantaged population, most of the Syrian community is not financially secure and has difficulty meeting the cost of living in Jordan. This study surveyed 36 Syrian women and interviewed 2 of them in order to determine the effects this policy has had on their maternal and reproductive health seeking …

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

Undergraduate Research 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 …