Women's Health Commons^™

The Community Health System In Bangladesh: An Overview, Frontline Health Project

Reproductive Health

This brief provides an overview of the community health system in Bangladesh. Bangladesh is divided into eight administrative divisions, 64 districts, and 545 subdistricts, known as upazilas. Each rural area within an upazila is divided into union parishads and mouzas, which are further divided into villages. The Ministry of Health and Family Welfare has an extensive health infrastructure that is pluralistic and follows the country’s administrative pattern. Union parishads are the smallest administrative unit in rural areas. At the lowest administrative level, traditional healers, nonqualified allopathic practitioners, and community health workers (CHWs) are typically the only providers available. This brief …

Implementation Process Brief: Integrated Family Planning And Hiv Services At The Community Level In Kenya, Wilson Liambila, Sara Chace Dwyer, Charlotte E. Warren, Aparna Jain, Melsa Lutomia, Jane Loech, Elizabeth Washika

Reproductive Health

Enabling women living with HIV to use contraception effectively can decrease unintended pregnancies and in turn reduce maternal mortality and vertical transmission of HIV. This brief describes the implementation process and intervention tested under the Evidence Project for delivering integrated FP and HIV services at the community level in Kenya. It outlines the implementation steps, best practices, and lessons learned of an intervention that was tested within the existing community health structure. Community health volunteers were trained to offer FP as part of their routine services to women living with HIV, and community health units were prepared to sustain those …

The Community Health System In Haiti: An Overview, Frontline Health Project

Reproductive Health

This brief provides an overview of the community health system in Haiti. In Haiti, the health system is overseen at the national level by the Ministry of Public Health and Population (Ministère de la Santé Publique et de la Population-MSPP) which provides policies and standards for service delivery at all levels, including the community level. Health service delivery is managed and coordinated across three levels: national (level III), health department (level II), and district and community levels (level I). The national level is guided by the MSPP and provides policy guidance for community-level service delivery. The Health Department level is …

Granulomatous Peritonitis Secondary To Chlamydia Trachomatis: A Case Report, Katelyn Tondo-Steele, Kellie Rath, Leo Niemeier

Women’s Health Articles

BACKGROUND: This case provides a rare case of

CASE: A 23-year old gravida 0 presented as a new patient to her gynecologist with complaints of irregular menses. A pelvic ultrasound showed ascites and the ovaries appeared heterogenous with irregular borders. A CA125 was 432. The patient was taken to the operating room by gynecologic oncology for a diagnostic laparoscopy. Biopsies were taken and final pathology resulted as "diffuse granulomatous inflammation." Post-operatively, the etiology remained unknown. The patient was brought back to the office for more testing. She tested positive for Chlamydia and was diagnosed with pelvic inflammatory disease.

CONCLUSION: When …

Pharmacist-Prescribed Birth Control: A Policy Analysis, Brianna Full

UNO Student Research and Creative Activity Fair

Although unintended pregnancy in the United States has steadily decreased from 2008, rates are still unacceptably high as almost half (42%) of all pregnancies are not wanted or timed correctly (Finer & Zolna). In 2011, 2.8 million of the 6.1 million pregnancies in the United States each year were unintended. Public health professionals are worried about unintended pregnancy because research shows that unwanted or mistimed pregnancies come with associations to adverse maternal and child health outcomes, such as delayed prenatal care, premature birth, and negative physical and mental health effects for children (Frost, Frohwirth & Zolna, 2016). Also, two-thirds (68%) …

Unintended Pregnancy Among The Lgbtq+ Population, Kenna M. Barnes

UNO Student Research and Creative Activity Fair

Unintended births are related to adverse health outcomes for both parents and children (Mosher, et al., 2012). For the context of this research, unintended will include both mistimed (too early) and unwanted (wanted to avoid pregnancy) pregnancies. Non-heterosexual women, defined as anyone who has same-sex sexual behaviors, attractions, or identities, make up about 5.1% of the population according to Williams Institute (2019). The impact of unintended pregnancy among non-heterosexual individuals is not well understood, creating large disparities in the community. This has manifested in emotional, physical, and social wellness gaps compared to their heterosexual counterparts (Buchmueller & Carpenter, 2010; Everett …

Assessing Physical Activity In People With Mental Illness: 23-Country Reliability And Validity Of The Simple Physical Activity Questionnaire (Simpaq), S Rosenbaum, R Morell, A Abdel-Baki, M Ahmadpanah, T V. Anilkumar, L Baie, A Bauman, S Bender, Zahra Hoodbhoy, Romaina Iqbal, Ayesha Mian

Department of Paediatrics and Child Health

Background: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness.
Methods: The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in …

Evaluation Of Program For Overcoming Intestinal Worm Infections Among Children, Henny Febriyanti, Haerawati Idris

Kesmas

Prevalence of intestinal worm infection in generall is extremely high in Indonesia among the poor population with poor sanitation. One of the government programs to address this problem is the distribution of medicines to prevent intestinal worm infections. However, the coverage of the achievement for this program is still low in several areas of public health centers in Palembang. Therefore, this study was conducted to evaluate the efficacy of the national program for preventing intestinal worm infections. The qualitative research design used evaluation model approach Context, Input, Process, and Product (CIPP) model. This study was conducted in one of health …

Qualitative Exploration Of Experiences And Consequences Of Health-Related Stigma Among Indonesians With Hiv, Leprosy, Schizophrenia And Diabetes, Sarju Sing Rai, Irwanto Irwanto, Ruth M.H. Peters, Elena V. Syurina, Annisa Ika Putri, Altana Mikhakhanova, Denise Naniche, Marjolein B.M. Zweekhorst

Kesmas

Health-related stigma causes a negative impact on the lives of affected people and undermines the effectiveness of public health programs. This study aimedto explore experiences and consequences of stigma among people affected by four health conditions relevant in Indonesia– HIV (Human ImmunodeficiencyVirus), leprosy, schizophrenia and diabetes. In this qualitative study 40 people affected by the four health conditions in Jakarta and West Java, Indonesia–,were interviewed between March and June 2018. Data were analyzed thematically by following an integrative inductive-deductive approach. The experiencesand consequences of people with stigma were similar, but such experience were more severe among people affected by HIV, …

Effects Of Diabetes On The Output Of Farmer And Its Policy Implications, Syed Asif Ali Naqvi, Bilal Hussain, Syed Ale Raza Shah, Muhammad Sohail Amjad Makhdum

Kesmas

This study investigated the impact of diabetes on work performance of different farming communities from Punjab, Pakistan. This study was based on cross-sectional data. A representative sample of 374 farmers was collected from five selected districts. Three types of respondents were analyzed in the study e.g.,laborer, small and large growers. Poisson and logistic regression techniques were used for the sake of analysis. According to the investigated results for thelabor category, respondents with more age, less qualification, low earning per month (Rupees), and having positive record of family diabetes, would havemore leave per month. In the same way, findings for small …

Health Risk Behaviors: Smoking, Alcohol, Drugs, And Dating Among Youths In Rural Central Java, Zahroh Shaluhiyah, Syamsulhuda Budi Musthofa, Ratih Indraswari, Aditya Kusumawati

Kesmas

Adolescents are more likely to adopt risky health behaviors, such as smoking, alcohol use, and sexual activity. This study examined the links betweensmoking, alcohol use, and risky dating behavior and analyzed how these factors influenced risky dating and other behaviors. It is expected that this studywould be used as a foundation for developing appropriate integrated intervention for multiple risk behaviors among youths. This study was an explanatory research study with a cross-sectional approach. It involved 160 youths aged 15-24 years randomly selected from purposive villages. Participants completedself-administrated questionnaires with an enumerator present. Data were analyzed using univariate, chi-square, and multiple …

Entomological Index And Home Environment Contribution­ ­To Dengue Hemorrhagic Fever In Mataram City, Indonesia, Tri Baskoro Tunggul Satoto, Nur Alvira Pascawati, Tri Wibawa, Roger Frutos, Sylvie Maguin, I Kadek Mulyawan, Ali Wardana

Kesmas

Indonesia is a member of Southeast Asia Regional Office (SEARO) ranked the first in dengue hemorrhagic fever (DHF) problem based on incidence rate (IR) and case fatality rate (CFR). Several provinces in Indonesia experience an outbreak, one of which is the Mataram City in West Nusa Tenggara Province. Mataram City is an endemic area of DHF because the DHF cases are always found in three consecutive years with the number of cases that fluctuate and tend to increase. This study aimed to obtain factors that could be used to improve early warning systems in controlling DHF. This study used a …

Utilization Of Family Planning Contraceptives Among Women Inthe Coastal Area Of South Buru District, Maluku, 2017, Christiana Rialine Titaley, Ninik Sallatalohy

Kesmas

Maluku Province is one among provinces in Indonesia with a contraceptive prevalence rate (CPR) lower than the national average. This study aimed toexamine factors associated with the utilization of family planning contraceptives among women of reproductive age living in the coastal area of South BuruDistrict, Maluku, Indonesia. Data were derived from a household health survey conducted in five subdistricts in South Buru, e.g., Namrole, Leksula, Waesama,Kapala Madan and Ambalau Subdistricts on November 2017 by the Faculty of Medicine, Pattimura University in Ambon. Information on contraceptive usewere collected from 390 married women aged 20 - 49 years. Bivariate and multivariate logistic …

Determinants Of Stunted Children In Indonesia: A Multilevel Analysis At The Individual, Household, And Community Levels, Febri Wicaksono, Titik Harsanti

Kesmas

This study aimed to examine the risk factors of childhood undernutrition in Indonesia. Determinants of childhood stunting were examined by using the 2013 Indonesia Basic Health Research Survey dataset. A total of 76,165 children aged under 5 years were included in this study. The analysis used multivariate multilevel logistic regression to determine adjusted odds ratios (aORs). The prevalence of stunting in the sample population was 36.7%. The odds of stunting increased significantly among the under-five boys, children living in slum area, and the increase of household member (aOR = 1.11, 95 %CI: 1.06–1.15; 1.09, 95%CI: 1.04–1.15; and 1.03, 95%CI: 1.02–1.04 …

Examining Access To Sexual And Reproductive Health Care Services And Information For Young Women With Physical Motor Disabilities In Dakar, Senegal, Olivia Soule, Diatou Sonko

Undergraduate Research Symposium

Access to and use of sexual and reproductive health (SRH) services in Senegal remains low despite local and international interventions and campaigns to increase contraception use, increase knowledge regarding Sexually Transmitted Infections (STI), and increase access to reproductive health services. Among marginalized groups, such as people living with disabilities, access to and use of services and information are even lower, and there are gaps in research involving Senegalese people with disabilities and their access to and use of SRH services and information. This mixed-methods, community-based participatory research examines how Senegalese women navigate their sexual and reproductive health care. It seeks …

Characterization Of Urinary Concentrations Of Heavy Metals Among Socioeconomically Disadvantaged Black Pregnant Women, Inkyu Han, Kristina W Whitworth, Xueying Zhang, Masoud Afshar, Pamela D Berens, Elaine Symanski

Faculty, Staff and Student Publications

The objective of this study was to characterize exposures to metals using biological samples collected on socioeconomically disadvantaged black pregnant women. We obtained 131 anonymous urine samples provided by black pregnant women visiting a Medicaid-serving prenatal clinic in Houston, TX, from March 27, 2017 to April 11, 2017. We analyzed urine samples for 15 metals including cadmium (Cd), arsenic (As), lead (Pb), and nickel (Ni) and for creatinine and cotinine. We found that median concentrations of zinc (Zn), selenium (Se), and aluminum (Al) among black pregnant women in this study were 1.5 to 3 times higher than levels reported among …

Shedding Light On Endometriosis: Patient And Provider Perspectives On A Challenging Disease, Madalene Zale, Emily Lambert, Marianna Lanoue, Amy E. Leader

College of Nursing Faculty Papers & Presentations

Background: Endometriosis is a serious yet understudied medical condition impacting millions of women worldwide.

Methods: This mixed methods study aimed to understand health care provider perceptions and patient experiences with endometriosis in the United States. Providers were surveyed to assess their understanding of disease prevalence. A subset of providers also participated in short, open-ended interviews about treating patients who have or are suspected to have endometriosis. Interviews were also conducted with women diagnosed with endometriosis to understand their experiences with the disease. Means and frequencies were calculated for survey data; interviews were transcribed and separately analyzed by two coders using …

Lack Of Food Access And Food Consumption Patterns Of Late Midlife Women In Southeast Michigan, Sarah S. Bassiouni, Ebony M. White, Carrie Karvonen-Gutierrez, Sioban D. Harlow

Michigan Journal of Public Health

Background: Food access is a key social determinant of health for older adults at high risk of chronic disease and physical disability.

Methods: This cross-sectional analysis examined correlates of food access and the relationship between food access and food consumption characteristics in a sample of 316 late midlife women from Southeast Michigan in 2015-2016.

Results: Lack of food access, defined as access to self-perceived adequate grocery shopping resources in one’s neighborhood, was reported by 20.9% of women. Women who reported lack of food access were less likely to report making meals at home (p=0.02) and had less frequent consumption of …

Medicaid Home Visitation And Maternal And Infant Care And Health: A Reassessment Of Program Effectiveness, Cristian Meghea, Zhiying You, Jennifer E. Raffo, Lee Anne Roman

Michigan Journal of Public Health

Introduction: The Maternal Infant Health Program, MIHP, is Michigan's largest home visiting program for Medicaid-eligible pregnant women and infants. Prior quasi-experimental propensity score matched MIHP evaluations were limited by the possibility of selection bias due to the limited available baseline characteristics. The purpose of this study was to assess the effectiveness of MIHP including previously unobserved baseline characteristics to mitigate the possibility of selection bias.

Methods: We analyzed health care and outcomes of mothers and their infants using linked administrative and screening data. All Medicaid pregnant women with a singleton birth in Michigan between 2009 and 2012 who were prenatally …

Hiv Pre‐Exposure Prophylaxis For Female Sex Workers: Ensuring Women’S Family Planning Needs Are Not Left Behind, Anna L. Bowring, Frances H Ampt, Sheree Schwartz, Mark A. Stoove, Stanley Luchters, Stefan Baral, Margaret Hellard

Population Health, East Africa

Introduction: Female sex workers (FSWs) experience overlapping burdens of HIV, sexually transmitted infections and unin- tended pregnancy. Pre-exposure prophylaxis (PrEP) is highly efficacious for HIV prevention. It represents a promising strategy to reduce HIV acquisition risks among FSWs specifically given complex social and structural factors that challenge consistent condom use. However, the potential impact on unintended pregnancy has garnered little attention. We discuss the potential concerns and opportunities for PrEP to positively or negatively impact the sexual and reproductive health and rights (SRHR) of FSWs.

Discussion: FSWs have high unmet need for effective contraception and unintended pregnancy is common in …

Tracing Change In Female Genital Mutilation/Cutting Through Social Networks: An Intersectional Analysis Of The Influence Of Gender, Generation, Status, And Structural Inequality, Amadou Moreau, Bettina Shell-Duncan

Reproductive Health

Policies and programs designed to eliminate female genital mutilation/cutting (FGM/C) in Senegal have been implemented over several decades, but the practice has been surprisingly tenacious. Strategies for accelerating abandonment have been informed by theories of change, and social norms theory, in particular, has become a prominent framework for understanding behavior change dynamics. FGM/C is held in place by interdependent normative expectations: what one family chooses to do is linked to expectations of others and reinforced through social sanctions. Hence, a key strategy for promoting behavior change rests on coordinating change in norms and behavior among people who interact with one …

Exploring The Nature And Extent Of Normative Change In Fgm/C In Somaliland, Richard A. Powell, Mohamed Yussuf, Bettina Shell-Duncan, Caroline W. Kabiru

Reproductive Health

More than 200 million girls and women alive today have undergone FGM/C across 30 countries in Africa, Asia, and the Middle East. While most affected countries have adopted legal frameworks prohibiting FGM/C, these have been varyingly effective in preventing the practice or significantly accelerating its abandonment. The success of programmatic interventions to address FGM/C has also been variable. One possible reason for the limited success of these initiatives is the neglect of the collectively held social norms underpinning the practice’s continuation. This study, conducted in 30 villages in Somaliland, aimed to investigate: 1) if the norms associated with FGM/C are …

Evaluating The Performance Of The Who International Reference Standard For Osteoporosis Diagnosis In Postmenopausal Women Of Varied Polygenic Score And Race, Qing Wu, Xiangxue Xiao, Yingke Xu

School of Medicine Faculty Research

Background: Whether the bone mineral density (BMD) T-score performs differently in osteoporosis classification in women of different genetic profiling and race background remains unclear. Methods: The genomic data in the Women’s Health Initiative study was analyzed (n = 2417). The polygenic score (PGS) was calculated from 63 BMD-associated single nucleotide polymorphisms (SNPs) for each participant. The World Health Organization′s (WHO) definition of osteoporosis (BMD T-score ≤ −2.5) was used to estimate the cumulative incidence of fracture. Results: T-score classification significantly underestimated the risk of major osteoporotic fracture (MOF) in the WHI study. An enormous underestimation was observed in African American …

Rural Primary Care And The Diagnostic Resolution Of Abnormal Screening Mammograms: A Mixed Methods Study In Rural Missouri, Jean Hunleth, Julia Maki, Amanda Lee, Aimee James, Rebecca Lobb

Journal of Health Disparities Research and Practice

Rural health clinics (RHCs) and federally qualified health centers (FQHCs) play a vital role in initiating cancer screening in underserved, rural settings. Yet there is limited information about their involvement in diagnostic tests when a mammogram result is abnormal. Diagnostic resolution of abnormal mammograms varies widely by geographic location and resources, and timely resolution is important for addressing rural-urban cancer disparities. This mixed methods study in a rural region of Missouri with high rates of cancer mortality examined the roles of primary care providers during follow-up after an abnormal mammogram, the processes they used, and the clinic specific variations among …

Factors Contributing To Domestic Violence Among Hindu Asian Indian Immigrant Women In Allegheny County, Pennsylvania: A Feasibility Study, Chelsea Pallatino, Todd Bear, Martha A. Terry

Journal of Health Disparities Research and Practice

While there is research on survivors of domestic violence in India and the United States (U.S.), little is known about the sociocultural factors related to domestic violence among Hindu Asian Indian immigrant women (AIIW) in the U.S. The objectives of this study were to a) test the feasibility of conducting domestic violence research among Hindu AIIW; b) investigate domestic violence prevalence and correlations with other characteristics; and c) test the cultural appropriateness of completed measures on social support, acculturation status, and domestic violence. Over 50% of respondents had experienced abuse, often perpetrated by family. Participants had high levels of social …

Loss Of Self In Dissociation In Prostitution; Recovery Of Self In Connection To Horses: A Survivor's Journey, Sandra Norak

Dignity: A Journal of Analysis of Exploitation and Violence

This narrative is about dissociation in the lives of women who have been exploited through prostitution. When we speak about prostitution, we do not speak often enough about the dissociation needed for women and girls to survive sexual exploitation. The author challenges the wisdom of governments such as Germany that legalize prostitution, treating it as a “job” and ignoring the violence and subsequent dissociation in women. The author describes her personal journey, explaining how women are traumatized even after the first commercial sex act, which is a sexual assault. They dissociate which makes their lives bearable, but they fail to …

Psychosocial Implications In Breast Cancer, Daniyal Aamir, Yamna Waseem, Mustafa Saleem Patel

Medical College Documents

No abstract provided.

Psychosocial Mediators Of Perceived Stigma And Suicidal Ideation Among Transgender Women, Krishna Kiran Kota, Laura F. Salazar, Rachel E. Culbreth, Richard A. Crosby, Jamal Jones

Health, Behavior & Society Faculty Publications

BACKGROUND: Transgender women (TGW) in the U.S. experience high rates of stigma, depression, and elevated rates of suicide. This study examined correlates of suicidal ideation and estimated the conditional indirect effects of perceived stigma and psychosocial mediators on suicidal ideation.

METHODS: Using a cross-sectional study design, TGW (N = 92) were recruited through snowball sampling in Atlanta, Georgia. Structured interviews were conducted. Suicidal ideation was assessed by combining two variables that measured suicidal thoughts. Logistic regression models were performed to identify the potential risk and protective factors for suicidal ideation. We examined hypothesized psychosocial factors, including anxiety, depression, psychosocial impact …

Does Age Affect The Association Between Race/Ethnicity And Hpv Screening: A Retrospective Cohort Study Of United States Women, Keila L. Marlin, Mph, Larissa R. Brunner Huber, Ph.D.

Journal of Health Disparities Research and Practice

Many studies have demonstrated disparities in awareness of and knowledge about human papillomavirus (HPV) among young, immigrant, and minority populations. Yet, there is a lack of existing research that has investigated the role of race/ethnicity and HPV screening, and how it varies by age. The purpose of this study was to evaluate this association using 2016 Behavioral Risk Factor Surveillance System (BRFSS) data. This study included 120,646 women who self-reported information on race/ethnicity, HPV screening, and age. Logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (CIs). A stratified analysis was conducted to determine if age …

Assessment Of Outcomes And Novel Immune Biomarkers In Metaplastic Breast Cancer: A Single Institution Retrospective Study., Evan Morgan, Anupama Suresh, Akaansha Ganju, Daniel G Stover, Robert Wesolowski, Sagar Sardesai, Anne Noonan, Raquel Reinbolt, Jeffrey Vandeusen, Nicole Williams, Mathew A Cherian, Zaibo Li, Gregory Young, Marilly Palettas, Julie Stephens, Joseph Liu, Amanda Luff, Bhuvaneswari Ramaswamy, Maryam Lustberg

Women’s Health Articles

BACKGROUND: Metaplastic breast cancer remains poorly characterized given its rarity and heterogeneity. The majority of metaplastic breast cancers demonstrate a phenotype of triple-negative breast cancer; however, differences in clinical outcomes between metaplastic breast cancer and triple-negative breast cancer in the era of third-generation chemotherapy remain unclear.

METHODS: We compared the clinical outcomes between women with metaplastic breast cancer and women with triple-negative breast cancer diagnosed between 1994 and 2014. Metaplastic breast cancer patients were matched 1:3 to triple-negative breast cancer patients by stage and age at diagnosis. Distant disease-free survival (DDFS) and overall survival (OS) were estimated using Kaplan Meier …