Women's Health Commons^™

Access To Reproductive Health And Hiv Services Among Young Mothers In Tanzania, Francis Obare, Annette Almeida, George Odwe, Jamilla Mwanga, Chi-Chi Undie, Maurice Hiza, Feddy Mwanga

Reproductive Health

This report presents findings from a Population Council study that examined the experiences of young mothers in Tanzania with accessing reproductive health and HIV services during pregnancy, delivery/pregnancy termination, and the postpartum period. The overall objective of the study was to generate evidence on access to reproductive health and HIV services among young mothers aged 12–19 years in Tanzania in order to inform programming and actions to better meet their needs. It specifically examined their experiences with accessing reproductive health (safe motherhood and contraception) and HIV (testing and counseling, PMTCT, antiretroviral therapy, and early infant diagnosis) services as well as …

Adolescent Friendly Health Corners (Afhcs) In Selected Government Health Facilities In Bangladesh: An Early Qualitative Assessment, Sigma Ainul, Iqbal Ehsan, Tasmiah Tanjeen, Laura Reichenbach

Reproductive Health

With high rates of early marriage, especially among girls, a significant proportion of adolescents in Bangladesh need sexual and reproductive health services (SRH), including contraceptive information. To address this gap and ensure that adolescents throughout the country, including unmarried adolescents, have access to SRH services through public health facilities, the Maternal and Child Health Services Unit of the Directorate General of Family Planning, with financial and technical assistance from development partners, has begun establishing Adolescent Friendly Health Corners (AFHCs) at selected government facilities at district and union levels. The Evidence Project/Population Council was asked to assess the implementation of the …

Assessing Community Midwives' Knowledge Of Pe/E Management In Sindh, Pakistan, Population Council

Reproductive Health

The Population Council conducted a landscape analysis in Pakistan to assess the knowledge and practices of trained community midwives in Tando Allahyar, a rural district of Sindh, India on the prevention, detection, and management of pre-eclampsia, severe pre-eclampsia, and eclampsia, as well as gaps and challenges around the prevention and treatment at the provincial and district levels. This brief shares the findings of that assessment, and provides recommendations that would minimize the gaps in maternal health services. In order to implement the key recommendations, the Ending Eclampsia project suggests the establishment of a task force comprised of members of professional …

Contribution Of Contraceptive Discontinuation To Unintended Births In 36 Developing Countries, Population Council

Reproductive Health

High contraceptive discontinuation results in millions of women having an unmet need for contraception. This Population Council study using data from 36 Demographic and Health Surveys shows that contraceptive discontinuation also results in millions of unintended pregnancies and births. This brief recommends attention to issues related to quality of care, such as counseling, to ensure that each woman has the method she needs/wants and uses it correctly. This will help women avoid contraceptive discontinuation and associated unmet need and unintended fertility right from the beginning. As programs become more successful, quality of care will become key to expanding contraceptive use …

Evaluation Of The Effectiveness Of The Herhealth Model For Improving Sexual And Reproductive Health And Rights Knowledge And Access Of Female Garment Factory Workers In Bangladesh, Md. Irfan Hossain, Abdullah Al Mahmud Shohag, Ashish Bajracharya, Ubaidur Rob, Laura Reichenbach

Reproductive Health

The Population Council, under its USAID-funded Evidence Project, partnered with Bangladesh’s Business for Social Responsibility program to conduct operational research to evaluate the effectiveness of the HERhealth model for improving female factory workers’ health, and to find ways to optimize program inputs and processes to support future scale-up of the intervention. This report presents findings from a pre- and post-intervention quantitative study of female factory workers from 10 factories; a qualitative study with factory managers, service providers, and implementing partners; and self-administered retention assessments of the Peer Health Educators from six factories in Dhaka, Gazipur, and Narayanganj districts. Findings from …

Evaluation Of The Herhealth Intervention In Bangladesh: Baseline Findings From An Implementation Research Study, Md. Irfan Hossain, Abdullah Al Mahmud Shohag, Ashish Bajracharya, Ubaidur Rob, Laura Reichenbach

Reproductive Health

The Business for Social Responsibility's (BSR) HERproject is a collaborative initiative that strives to empower low-income women working in global supply chains in 14 countries worldwide. One of the HERproject’s three pillars is HERhealth, which seeks to improve the health-related knowledge and behaviors, and access to health services and products, of low-income working women. In Bangladesh, HERhealth specifically addresses reproductive health and family planning needs. BSR asked the Evidence Project/Population Council to conduct an implementation science study assessing the effectiveness of BSR’s HERhealth model in Bangladesh. This study is one of the first studies of female garment workers in Dhaka …

Exploring The Association Between Fgm/C And Early/Child Marriage: A Review Of The Evidence, Jamlick Karumbi, David Gathara, Jacinta Muteshi-Strachan

Reproductive Health

Female genital mutilation/cutting (FGM/C) has been frequently linked to marriageability and thought to be associated with child marriage, yet there is remarkably little rigorous research to clarify the relationship between these two practices to inform discussions and responses. Furthermore, trends are also shifting in the timing of FGM/C from adolescence to early childhood, and the implications this might have on the links between early/child marriage and FGM/C are not well understood. This review of current available evidence aims to assess the association between FGM/C and early/child marriage in contexts where both practices are carried out. The social and cultural norms …

Exploring The Association Between Fgm/C And Fistula: A Review Of The Evidence, Pooja Sripad, Charity Ndwiga, Kaji Tamanna Keya

Reproductive Health

Female genital mutilation/cutting (FGM/C) and fistula are both conditions that have a range of health, socioeconomic, and lifestyle causes and consequences for women globally. There have been sparse empirical and conceptual efforts to look at how these two conditions manifest and relate to one another. This rigorous review of the literature aims to fill this research gap by assessing the state of evidence on the association of FGM/C and fistula and conceptually mapping this association within broader social, political, and health-systems contexts. Based on the findings, the authors of this report have developed a conceptual mapping framework to situate the …

Garment Sector Health Interventions In Cambodia: A Comprehensive Review, Molyaneth Heng, Ashish Bajracharya

Reproductive Health

As part of the WorkerHealth project, the Evidence Project/Population Council conducted a comprehensive review of garment sector health interventions, particularly reproductive health (RH) and family planning (FP)–focused projects, in Cambodia during the last five years. The results from the review support WorkerHealth’s objective of enabling evidence-based decisionmaking and programming related to the health and well-being of female garment factory workers in Cambodia, by documenting the range of garment sector health interventions and identifying best practices and gaps in programming and evaluation. This review identified a number of priority actions for current and future garment sector health interventions to consider in …

Health Needs, Health Seeking Pathways, And Drivers Of Health Seeking Behaviors Of Female Garment Factory Workers In Cambodia: Findings From A Qualitative Study In Phnom Penh And Kandal Provinces, Population Council, The Evidence Project

Reproductive Health

Existing information on Cambodian garment factory workers’ (GFWs) barriers to health services has generally come from project implementation documents or general baseline studies of these projects, rather than independent, rigorous studies that specifically examine the health needs and health-seeking behaviors of workers. Since previous studies did not include specific indicators related to workers’ health needs and health-seeking behaviors, they cannot offer a complete picture of these important issues. To fill this critical knowledge gap, in partnership with the National Institute of Public Health, the Evidence Project/Population Council conducted a formative qualitative study under the USAID-funded WorkerHealth project to improve the …

Indicators For Measurement And Improvement Of The Quality Of Family Planning Programs: The Philippines, 1997–1998, Population Council

Reproductive Health

Quality is a critical dimension of health service provision and this brief aims to highlight the creation and use of indicators for quality of care to enhance the achievement of the reproductive health goals in the Philippines and beyond. In response to the need for program managers to understand the quality of services at the field level, the Situation Analysis approach was developed. The research underscores the importance of a composite index when measuring quality. In the case of the Philippines, the evidence suggests the need for more quality-of-care monitoring in addition to expanded access to contraceptives. Investment in counseling …

Increasing Access To Reproductive Health Care Through Improved Service Delivery, Gul Rashida, Iram Kamran, Muhammad Khalil, Zeba Tasneem, Rehan M. Niazi, Mumraiz Khan, Tahira Parveen

Reproductive Health

The study documented in this report examines the provision and utilization of public and private sector maternal and child health services in Punjab, Pakistan with a focus on family planning (FP) services. It is aimed at enabling a better understanding of the specific demand and supply dynamics leading to low contraceptive prevalence despite unmet need, and the opportunities that must be seized to enhance access to quality family planning services. The report is part of a larger project being implemented by the Population Council with the assistance of the Department for International Development, UK entitled “Sustaining Focus on Provincial Governments …

Married Young Women And Girls' Family Planning And Maternal Heath Preferences And Use In Ethiopia, Aparna Jain, Elizabeth Tobey, Hussein Ismail, Annabel Erulkar

Reproductive Health

Married young women and girls are the primary users of youth-centered sexual and reproductive health services in Ethiopia and, given the health risks associated with early and closely-spaced pregnancies, represent an especially important population to reach with sexual and reproductive health services. This brief looks specifically at the needs and preferences for family planning and reproductive health services among married young women and girls, with recommendations for how to more effectively ensure that they have access to those services.

Policies For Pre-Eclampsia And Eclampsia Prevention And Management In Bangladesh, Kanij Sultana, Amy Dempsey

Reproductive Health

Bangladesh experiences between 5,000 and 6,000 maternal deaths each year. Of those deaths, 20 percent are from pre-eclampsia and eclampsia (PE/E), the second most common direct cause of maternal mortality in the country. In Bangladesh, best practices to prevent PE/E using aspirin and calcium and managing it through task sharing and use of magnesium sulphate and anti-hypertensive drugs have not been optimally examined. To appreciate the enormity of the problem, the Population Council conducted a landscape analysis in 12 upazilas in four districts. The study was cross sectional, and data collection activities included in-depth interviews (IDIs) with policymakers, development partners, …

Reducing Barriers To Accessing Fistula Repair: Establishing A Baseline In Ebonyi, Population Council

Reproductive Health

As a partner on the Fistula Care Plus (FC+) project, the Population Council is conducting implementation research that tests solutions to treatment barriers. Formative research in Nigeria’s Ebonyi State found that a lack of knowledge among lower-level providers and women and families of how the condition occurs, where treatment is available, and the signs and symptoms of obstetric fistula, as well as transportation costs, affect women’s access to screening and repair. Baseline data reveal the necessity of a comprehensive intervention to address fistula treatment barriers in Ebonyi. Not only do primary healthcare providers lack adequate knowledge of fistula, referral, and …

Reducing Barriers To Accessing Fistula Repair: Establishing A Baseline In Katsina, Population Council

Reproductive Health

As a partner on the Fistula Care Plus (FC+) project, the Population Council is conducting implementation research that tests solutions to treatment barriers. Formative research in Nigeria’s Katsina State found that a lack of knowledge among lower-level providers and women and families of how the condition occurs, where treatment is available, and the signs and symptoms of obstetric fistula, as well as transportation costs, affect women’s access to screening and repair. Baseline data reveal the necessity of a comprehensive intervention to address fistula treatment barriers in Katsina. Not only do primary healthcare providers lack adequate knowledge of fistula, referral, and …

Reducing Barriers To Accessing Fistula Repair: Establishing A Baseline In Uganda, Population Council

Reproductive Health

As a partner on the Fistula Care Plus (FC+) project, the Population Council is conducting implementation research that tests solutions to treatment barriers. Formative research in Uganda found that a lack of knowledge among lower-level providers and women and families of how the condition occurs, where treatment is available, and the signs and symptoms of obstetric fistula, as well as transportation costs, affect women’s access to screening and repair. Baseline data reveal the necessity of a comprehensive intervention to address fistula treatment barriers in Uganda. Not only do primary healthcare providers lack adequate knowledge of fistula, referral, and counseling, but …

Results From Systematic Literature Review On Pe/E In Bangladesh, Karen Kirk, Amy Dempsey

Reproductive Health

By 2015, at the conclusion of the Millennium Development Goals, Bangladesh had achieved a reduction in maternal death from 550 per 100,000 live births in 1990, to 170 maternal deaths per 100,000 live births in 2015. Despite this progress, there are still between 5,000 and 6,000 maternal deaths every year in Bangladesh, where 20 percent are the result of pre-eclampsia and eclampsia (PE/E). This systematic review of peer-reviewed literature published between January 2000 and July 2016 identified interventions adopted to manage PE/E throughout Bangladesh. Specifically, it looked at issues around quality of care, gaps in the evidence, and barriers to …

Results From Systematic Literature Review On Pe/E In Nigeria, Amy Dempsey, Karen Kirk

Reproductive Health

Pre-eclampsia and eclampsia (PE/E), hypertensive disorders of pregnancy, are consistently cited as a leading cause of maternal and newborn morbidity and mortality in Nigeria. A recent, nationwide cross-sectional survey found that PE/E contributes to 28.2 percent of national maternal deaths. The other main contributors to maternal mortality are hemorrhage and pregnancy-related infection or sepsis. To fully understand the key challenges, gaps, and interventions related to the prevention and treatment of PE/E, the Ending Eclampsia project conducted a systematic review of papers on PE/E in Nigeria published between 2000–15. The methods, results, and recommendations are discussed in this brief.

Workplace Health And The Garment Sector In Cambodia, Bunmey Yat, Carolyn Rodehau, David Wofford, Ashish Bajracharya

Reproductive Health

In Cambodia, there has been considerable investment in improving the well-being of factory workers. Understanding the key stakeholders and their roles in improving worker health is essential for policy change and ensuring that interventions achieve sustainable, long-term impact in and around the workplace. This policy brief presents selected findings from a stakeholder and situational analysis undertaken by the Cambodia Worker Health Coalition (WorkerHealth) to understand the stakeholder landscape and policy environment for women’s health in the garment industry in Cambodia, with the objective of identifying leading stakeholders and their relationships, as well as strategies and opportunities for collaboration. Collaboration and …

Uganda Retail Audit: Analysis And Report, The Evidence Project

Reproductive Health

This brief presents results of a retail audit, carried out in January 2016, that was commissioned as part of PATH’s work under the USAID-funded Evidence Project to conduct a landscape assessment of the feasibility of a Total Market Approach (TMA) in Uganda. This project also involved key informant interviews with stakeholders on their attitudes toward TMA principles and the collection of a Uganda Market Research Summary of existing family planning knowledge. The approach is based on an understanding that equitably meeting the diverse needs of different population segments requires increased coordination across sectors, including the public, private for-profit, and not-for-profit …

The Benefits And Concerns Of Veganism In Women's Health, Elisa R. Hester

Senior Honors Theses

There are many health benefits of consuming a vegan diet. It is associated with a decreased incidence of obesity, cardiovascular disease, type two diabetes, and a variety of cancers. Despite its numerous benefits, there are several concerns for consumers of a vegan diet, including nutrient deficiency and cardiovascular risk associated with consumption of coconut oil. However, many nutrients of highest concern, such as calcium and protein, are not needed in as high amounts as is commonly believed and recommended. Moreover, it is possible for vegans to obtain adequate nutrition with proper education despite restriction of animal products. Coconut oil consumption …

Disparities In Breast Cancer Stage At Diagnosis: Importance Of Race, Poverty, And Age, Faustine Williams, Emmanuel Thompson

ETSU Faculty Works

This study investigated the association of race, age, and census tract area poverty level on breast cancer stage at diagnosis. The study was limited to women residing in Missouri, aged 18 years and older, diagnosed with breast cancer, and whose cases were reported to the Cancer Registry between 2003 and 2008. The risk, relative risk, and increased risk of late-stage at diagnosis by race, age, and census tract area poverty level were computed. We found that the odds of late-stage breast cancer among African-American women were higher when compared with their white counterpart (OR 1.433; 95% CI, 1.316, 1.560). In …

Sex With Sweethearts: Exploring Factors Associated With Inconsistent Condom Use Among Unmarried Female Entertainment Workers In Cambodia, Siyan Yi, Sovannary Tuot, Pheak Chhoun, Khuondyla Pal, Chanrith Ngin, Kolab Chhim, Carinne M. Brody

Background: Despite the success in promoting condom use in commercial relationships, condom use with regular, noncommercial partners remains low among key populations in Cambodia. This study explores factors associated inconsistent condom use with sweethearts among unmarried sexually active female entertainment workers (FEWs).

Methods: In 2014, the probability proportional to size sampling method was used to randomly select 204 FEWs from entertainment venues in Phnom Penh and Siem Reap for face-to-face interviews. Multivariate logistic regression analysis was conducted to examine independent determinants of inconsistent condom use.

Results: Of total, 31.4% of the respondents reported consistent condom use with …

Hiv Prevalence And Factors Associated With Hiv Infection Among Transgender Women In Cambodia: Results From A National Integrated Biological And Behavioral Survey, Srean Chhim, Chanrith Ngin, Pheak Chhoun, Sovannary Tuot, Cheaty Ly, Phalkun Mun, Siyan Yi

Objective To examine factors associated with HIV infection among transgender women in Cambodia.

Design Cross-sectional study.

Settings HIV high-burden sites including the capital city and 12 provinces.

Participants This study included 1375 sexually active transgender women with a mean age of 25.9 years (SD 7.1), recruited by using respondent-driven sampling for structured questionnaire interviews and rapid finger-prick HIV testing.

Primary outcome measure HIV infection detected by using Determine antibody test.

Results HIV prevalence among this population was 5.9%. After adjustment for other covariates, participants living in urban areas were twice as likely to be HIV infected as those living in …

A Systematic Review: The Prenatal And Postnatal Events Associated With Infant Mortality Rate (Imr), Ariel L. Thomas, Sarah A. Awwad, Briana E. Clark

Williams Honors College, Honors Research Projects

Infant mortality rate (IMR) is an indication of overall population health, maternal and child health, accessibility and quality of primary health care, and the availability of community resources. The current IMR in the United States is high despite advances made in the medical field. The purpose of our systematic review is to describe and critically appraise research about prenatal events, postnatal events, and increased infant mortality rate and to give nursing practice recommendations to help decrease the rate. We used CINAHL, Medline and PubMed to find 20 research articles. Overall, the research stated that going to prenatal visits had a …

Experiences Of Postpartum Women In One Residential Treatment Facility For Substance Use Disorders: A Qualitative Case Study, Rebecca Jo Williams

Online Theses and Dissertations

A growing opioid crisis in the United States has sparked a need for gender-specific research and treatment to address unmet needs and promote positive health outcomes for both women and children. The primary purpose of this research is to provide insight into the experiences and perceptions of postpartum women with substance use disorders receiving care at one residential treatment facility. Two women, aged 22 and 27 years old, participated in semi-structured interviews designed to elicit perceptions about barriers to treatment, the value of various programs, the role of physical, social, and temporal contexts in treatment, and beliefs about the effect …

Development And Implementation Of A Nutritional-Risk Screening Procedure For Pregnant Mothers In A Honduran Community Hospital System, Maria Lamontagne, Brian Miller, Tanya Falcone

Williams Honors College, Honors Research Projects

Previous research has demonstrated the negative implications that poor maternal nutrition has on morbidity and mortality for both the mother and the unborn child. Although malnutrition is known to make pregnant women susceptible to miscarriage or birth of a child with stunted growth and development, many Central American countries such as Honduras lack a screening tool to detect maternal malnutrition. The purpose of this study was to develop and pilot a screening protocol for malnutrition during pregnancy using best practice and evidence-based recommendations from the AND and the ACOG, and creating a training protocol for obstetric nurse education to foster …

Sustainable Adapted Treatments For Eating Disorders: The Role Of Cultural Adaptation In Prevention, Sarah J. Javier

Theses and Dissertations

Despite demonstrating eating disorder rates equivalent to White women, African American and Asian American women are less likely to seek treatment and are more likely to terminate treatment prematurely. One of the most successful programs for eating disorder prevention has only focused on surface-level cultural adaptations. Prevention literature maintains that deep-structure cultural adaptation (e.g., integrating cultural values and beliefs) can enhance outcomes for ethnic minorities. This dissertation examined the feasibility of Sustainable Adapted Treatments for Eating Disorders (SATED), a pilot intervention that included a culturally- targeted pre-treatment to an eating disorder dissonance-based intervention. A sample of 72 women (ages 18-30) …

Universal Coverage In Developing Countries: A Summative Evaluation Of Maternal Policies In Ghana And Burkina Faso, Kiswendsida Aida Sawadogo

College of Graduate Studies: Theses & Dissertations

The Word Health Organization (WHO) has declared health to be a fundamental human right, yet more than 400 million people around the world do not have access to essential health services. Millions of Africans are unable to access or afford needed services without sustaining economic hardship. Sub-Saharan Africa is behind the rest of the world on coverage of essential health services such as planning, immunization, and sanitation and continues to grapple with higher rates of child mortality, maternal death, and communicable diseases. Despite bearing 25 percent of the world’s disease burden, the region only retains 3 percent of its doctors. …