Maternal and Child Health Commons^™

Building Evidence To Guide Prep Introduction For Adolescent Girls And Young Women, Nanlesta Pilgrim, Sanyukta Mathur, Ann Gottert, Naomi Rutenberg, Julie Pulerwitz

HIV and AIDS

This document was developed by the Population Council, with support from the Bill & Melinda Gates Foundation, to provide DREAMS country teams with practical guidance on building evidence to guide pre-exposure prophylaxis (PrEP) introduction for adolescent girls and young women (AGYW). The primary audiences for this document are health policymakers and program planners who will be making decisions about how PrEP is introduced and the researchers who will assess AGYW’s specific needs and experiences. Our aim is to complement emerging global guidance on PrEP and ongoing work regarding delivery platforms, marketing, and policy and regulatory frameworks for PrEP introduction more …

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 …

Family Planning Knowledge, Attitudes, And Practices Among Married Men And Women In Rural Areas Of Pakistan: Findings From A Qualitative Need Assessment Study, Ghulam Mustafa, Syed Khurram Azmat, Waqas Hameed, Safdar Ali, Muhammad Ishaque, Wajahat Hussain, Aftab Ahmed, Erik Munroe

Community Health Sciences

This paper presents the findings of a qualitative assessment aimed at exploring knowledge, attitudes, and practices regarding family planning and factors that influence the need for and use of modern contraceptives. A descriptive exploratory study was conducted with married women and men aged between 15 and 40. Overall, 24 focus group discussions were conducted with male and female participants in three provinces of Pakistan. The findings reveal that the majority knew about some modern contraceptive methods, but the overall contraceptive use was very low. Knowledge and use of any contraceptive method were particularly low. Reasons for not using family planning …

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 …

'Makin' It Out': The Cost Of Dropping Out Of High School On The Health Status Of Afro-American Women In Urban Slums, Sesa E. Bakenra-Tikande

CMC Senior Theses

“We carry our histories in our bodies, how could we not?” – Nancy Krieger

In the United States and abroad, socioeconomic status (income, education, and occupation) greatly impacts health outcomes for a given population. There is a strong and consistent socioeconomic gradient within health outcomes which has been documented as far back as in Ancient Egypt and China (Krieger, Willains, & Moss, 1997; Liberatos, Link, & Kelsey, 1988) The general trend shows that individuals with higher socioeconomic status generally enjoy lower rates of morbidity (disease) and disability, which can ultimately lead to higher mortality rates (House et al. (1992) and …

Promoting Respectful Maternity Care Resource Package—Implementing Respectful Maternity Care In Kenya, Population Council

Reproductive Health

The Respectful Maternity Care (RMC) Resource Package was developed by the Heshima project as part of the USAID Translating Research into Action (TRAction) project. The resource package is designed to be used by program managers, supervisors, trainers, technical advisors, and others who organize or facilitate RMC training workshops on sexual and reproductive health as well as skills training in emergency obstetric and newborn care. The resource package provides experienced facilitators with background information, materials, instructions, and tips for promoting respectful care in reproductive, maternal, and newborn health services in both facilities and communities. The resource package also includes tools for …

Contraceptive Use And Fertility Intentions Among Women Living With Hiv In Kenya And Swaziland, Integra Initiative

Reproductive Health

At the end of 2013, an estimated 35 million people were living with HIV, and sub-Saharan Africa was disproportionately affected. With major efforts directed at expanding access to life-saving antiretroviral therapy in sub-Saharan Africa, many people are living longer with HIV, leading productive and sexually active lives. Unintended pregnancies and the potential of vertical transmission are some of the challenges faced by women living with HIV. Understanding the fertility preferences and reproductive decisions of these women is vital for informing efforts to enable them to achieve these desires effectively and safely. The “Steps to Integration” series provides a guide on …

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 …

Pregnancy Outcome In Women With Antiphospholipid Syndrome On Low-Dose Aspirin And Heparin: A Retrospective Study., T. Naru, Rozilla Sadia Khan, R. Ali

Department of Obstetrics & Gynaecology

This retrospective review of hospital records analysed pregnancy outcome with 2 different treatments for women with recurrent miscarriage diagnosed with antiphospholipid syndrome in the index pregnancy. Of 64 women, 29 had received aspirin and 35 aspirin plus heparin. Pregnancy-induced hypertension, prematurity, intrauterine growth restriction and neonatal death were considered as maternal and fetal complications. There were no significant differences in antenatal and maternal complications between the groups. However, there were significant differences in mean anticardiolipin IgG antibody levels. Aspirin alone or in combination with parin was equally efficacious in women with antiphospholipid syndrome and recurrent miscarriage.

Leave No Woman Behind, Ethiopia: Baseline Report, Annabel Erulkar, Tekle-Ab Mekbib, Helen Amdemikael, Garry Conille

Poverty, Gender, and Youth

“Leave No Woman Behind, Ethiopia” is an experimental project being implemented in rural areas of Ethiopia’s Amhara region. The project uses the mobilization of women into groups and adult literacy as an entry point for reproductive health education and referrals. Measurement of the program’s impact is being undertaken using a quasi-experimental research design including baseline and endline surveys in six Kebele Associations in rural Amhara. This report presents findings from the baseline survey conducted among more than 3,000 girls and women aged 10–45 in rural Amhara region. The results cover a broad range of topics including education, work, livelihoods, social …

Sola No Eres Nada, Juntas Flotamos: El Movimiento Manuela Ramos, Judith Bruce, Debbie Rogow

Poverty, Gender, and Youth

This edition of Quality/Calidad/Qualité discusses the Manuela Ramos Movement and its efforts to improve women’s health and well-being through a range of empowerment strategies in rural Peru. A joint project with USAID, named Reprosalud, demonstrates how combining the resources of an international donor with local women’s organizations allows a more organic and multifaceted family planning program to develop. Such programs can produce impressive improvements on a number of indicators, including contraceptive use.

Rubella Vaccine And Medical Policymaking: Fetal Rights And Women's Health, Jacob Heller

New England Journal of Public Policy

U.S. vaccine policies, to all appearances, are based on assumptions about cost effectiveness, safety, and public health needs. Analysis of the peer review health professions’ discourse about rubella vaccine between 1941 and 1999 challenges this view. There were four justifications for the development of the vaccine: (1) cost-benefit projections about vaccine use versus anticipated birth defects; (2) the desire to prevent “fetal wastage” by vaccinating women; (3) a professional imperative to ensure healthy babies; and (4) a bias among vocal vaccine advocates against “unnecessary” abortion. The role of a fifth consideration, the “cultural provenance” of vaccines for American medicine, though …

Greater Investments In Children Through Women's Empowerment: A Key To Demographic Change In Pakistan?, Valerie L. Durrant, Zeba Sathar

Poverty, Gender, and Youth

Women’s status has received considerable attention as a significant factor in demographic behavior and outcomes in South Asia however, little research has addressed the links between women’s status and their investments in children. In this paper, we empirically investigate how women’s status on multiple levels is associated with demographic outcomes. Using data from the Pakistan Status of Women and Fertility Survey in rural Punjab, we confirm that empowered women, or those with higher status, are better able to make positive investments in their children, thus increasing their children’s chances of survival during infancy and increasing their likelihood of ever attending …

Integrating A Reproductive Health Framework Within Primary Care Services: The Experience Of The Reproductive Health Intervention Study, Karima Khalil, Abdel Moneim Farag, Assem Anwar, Dina Galal, Olfia Kamal, Karraze Shorbagi, Miral Breebaart, Hind Khattab, Nabil Younis, Huda Zurayk

Reproductive Health

This paper is part of the Policy Series in Reproductive Health, which shares research undertaken by the Reproductive Health Working Group (RHWG). It describes the Reproductive Health Intervention Study, which designed and tested a model of essential reproductive health (RH) services. RHWG was established in 1988 as part of a special program on the health of women and children within the context of the family and community initiated by the Population Council’s Regional Office for the West Asia and North Africa region. The paper identifies a framework of basic service components that address RH and shows that their delivery is …

Strengthening Reproductive Health Services In Africa Through Operations Research, Population Council

Reproductive Health

The health status of women, men, and children in sub-Saharan Africa remains the poorest in the world. Moreover, virtually every country in the region is suffering mediocre economic growth or economic decline, thereby reducing the ability of their health care systems to respond adequately, and increasing dependence on external donor assistance. In terms of reproductive health (RH), the region is faced with high levels of unwanted fertility; high levels of maternal, child, and infant morbidity and mortality; and an almost exponential growth in HIV prevalence. Access to and quality of RH services remains poor in most countries, thereby maintaining unmet …

Reproductive Decisionmaking In The Context Of Hiv/Aids In Ndola, Zambia, Naomi Rutenberg, Ann E. Biddlecom, Frederick A.D. Kaona

Reproductive Health

Family planning (FP) programs are increasingly being considered as a logical focal point for STD and HIV/AIDS prevention services because they serve large numbers of women at risk, address the sensitive issue of sexual behavior and fertility control, and the methods for preventing unwanted pregnancy and disease can be the same. FP programs, by providing contraceptive methods, are currently one of the few sources of assistance in the sub-Saharan African region for preventing perinatal transmission of HIV, while the promotion of barrier methods contributes to the prevention of heterosexual transmission. Given this potential, research is needed to understand how the …

Integrating Rti Services In Primary Health Care System: Observations From An Operations Research In Uttar Pradesh, India, M.E. Khan, Saumya Ramarao, R.B. Gupta, Bella C. Patel, Leila Caleb-Varkey, Jayanti Tuladhar, Sanjeev Kumar, John Townsend

Reproductive Health

Evidence from community studies indicates that significant proportions of Indian women (30 percent) may have reproductive tract infections (RTIs). Given that women are in general asymptomatic and that even symptomatic women may not seek care, the estimates are the minimum levels of prevalence. Most women do not seek treatment for RTIs for such reasons as lack of awareness, acceptance that RTIs are part of women's lives, and lack of treatment facilities. On the supply side, in the public sector the treatment for RTIs is limited with most services provided through STD clinics in urban areas. Seeking treatment at STD clinics …

Iron Supplementation: Knowledge, Perceptions, And Usage Among Pregnant Women In Rural India, Jayanti Tuladhar, John Townsend, Nazir Haider, Leila Caleb-Varkey

Reproductive Health

In India, severe anemia has been one of the causes of high maternal mortality and death of newborns and infants due to low birthweight. The prevalence of anemia among women ages 15–44 is extremely high. The Government of India has provided iron and folic acid tablets (IFA) as a prophylaxis against nutritional anemia among pregnant women as part of the Child Survival and Safe Motherhood program and will continue to do so in the Reproductive and Child Health package. This paper presents findings of both qualitative and quantitative research conducted among pregnant women to investigate the extent of distribution and …

El Cuidado Infantil: Respuestas A Las Necesidades De Madres Que Trabajan Y Sus Hijos, Caroline Arnold, Jorge Mejia, Aster Haregot, Ann Leonard, Cassie Landers

Poverty, Gender, and Youth

Este número de SEEDS, desarrollada en cooperación con el Grupo Asesor sobre Cuidado y Desarrollo Infantil, y apoyada por UNICEF, busca reunir los elementos críticos del trabajo de la mujer y el cuidado infantil, estudiando el tema desde tres perspectivas: el cuidado infantil como servicio que permite que la mujer pueda trabajar, como fuente de empleo para la mujer, y como respuesta a los requerimientos del desarrollo infantil. Examina tres distintos tipos de cuidado infantil apoyados por UNICEF en tres continentes—Asia (Nepal), Africa (Etiopia), y América Latina (Ecuador). Los tres proyectos fueron desarrollados específicamente para madres que trabajan, y dos …

Child Care: Meeting The Needs Of Working Mothers And Their Children, Caroline Arnold, Jorge Mejia, Aster Haregot, Ann Leonard, Cassie Landers

Poverty, Gender, and Youth

This issue of SEEDS, developed in cooperation with the Consultative Group on Early Childhood Care and Development, with support from UNICEF, seeks to bring together the critical elements of women's work and child care, reviewing the issues from three different perspectives: child care as a means of enabling women to work, as a source of employment for women, and as a way of meeting the developmental needs of young children. The report examines three different UNICEF-supported approaches to child care on three different continents—Asia (Nepal), Africa (Ethiopia), and South America (Ecuador)—that have been developed with the needs of working women …

Prostitution And Hiv Infection: Women, Aids, & Activism, Polly Thistlethwaite, Zoe Leonard

Publications and Research

This "Prostitution and HIV Infection" chapter of the ACT UP/NY Women & AIDS Book Group's Women, AIDS & Activism reflects the scientific, feminist, gay, lesbian, HIV-community work that informed ACT UP/NY's activism and analysis on women and HIV infection up to 1990. Book Group members: Marion Banzhaf, Cynthia Chris, Kim Christensen, Alexis Danzig, Risa Denenberg, Zoe Leonard, Deb Levine, Samuel Lurie, Monica Pearl, Catherine Gund, Polly Thistlethwaite, Judith Walker, and Brigitte Weil. Additional members of the original Women and AIDS Handbook Group included Jamie Bauer, Heidi Dorow, Maria Maggenti, Ellen Neipris, Ann Northrop, Sydney Pokorney, Karen Ramspacher, Maxine Wolfe, and …