Health Policy Commons^™

Concurrent Sexual Partnerships Do Not Explain The Hiv Epidemics In Africa: A Systematic Review Of The Evidence, Larry Sawers, Eileen Stillwaggon

Economics Faculty Publications

The notion that concurrent sexual partnerships are especially common in sub-Saharan Africa and explain the region’s high HIV prevalence is accepted by many as conventional wisdom. In this paper, we evaluate the quantitative and qualitative evidence offered by the principal proponents of the concurrency hypothesis and analyze the mathematical model they use to establish the plausibility of the hypothesis.

We find that research seeking to establish a statistical correlation between concurrency and HIV prevalence either finds no correlation or has important limitations. Furthermore, in order to simulate rapid spread of HIV, mathematical models require unrealistic assumptions about frequency of sexual …

Drive Alive: Teen Seat Belt Survey Program, Katie M. Burkett, Steve Davidson, Carol Cotton, James Barlament, Laurel Loftin, James H. Stephens, Martin Dunbar, Ryan Butterfield

Health Policy & Management: Faculty Publications (2006-2018)

Objective: To increase teen seat belt use among drivers at a rural high school by implementing the Drive Alive Pilot Program (DAPP), a theory-driven intervention built on highway safety best practices.

Methods: The first component of the program was 20 observational teen seat belt surveys conducted by volunteer students in a high school parking lot over a 38-month period before and after the month-long intervention. The survey results were published in the newspaper. The second component was the use of incentives, such as gift cards, to promote teen seat belt use. The third component involved disincentives, such as increased police …

Strengthening Primary Care To Bend The Cost Curve: The Expansion Of Community Health Centers Through Health Reform, Leighton C. Ku, Patrick Richard, Avi Dor, Ellen Tan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The recent enactment of health reform sets into motion important changes that will expand health insurance coverage, increase funding for community health centers and alter the way that health centers are paid. These reforms will have a major impact on two major challenges of health reform: bolstering the capacity of the nation's primary care system and reducing the long term growth in health care costs.

Our analyses examine the impact of the new health reform law on the number of patients who will receive primary care services at community health centers and the effect of the service expansions on overall …

Barriers And Facilitators To Prenatal Care For Pregnant Latina Women In Cobb County, Georgia, Carol Holtz, Annette Bairan

Journal of Global Initiatives: Policy, Pedagogy, Perspective

This research study seeks to identify factors that serve as barriers and/or facilitators to prenatal care for Latina women and to provide data to assist health care providers, health care agencies, and policy makers in developing programs that maximize access to prenatal care for Latina women. In addition, other groups may also find this data useful, such as scholars in Latin American studies, immigration, cultural diversity, minority health care, and health care in general. The research questions consist of the following: (1) What do indigent pregnant (or recently delivered) Latina women believe about prenatal care? (2) What are the barriers …

Early Childhood Care And Education For All In 2015: Is This A Mirage In Nigeria?, Esther A. Oduolowu

Journal of Global Initiatives: Policy, Pedagogy, Perspective

This paper examines the possibility of the provision of Early Childhood Care and Education (ECCE) for all children from birth to age five in Nigeria by 2015. In the paper are the history of preschool education in Nigeria) situation of ECCE worldwide in the 1980s) and the, global trends in basic education in the 1990s. The paper also examines the limitations of the attempt and offers probable solutions.

Forced Migration And The Survival Needs Of The Nigerian Child, Ngozi Diwunma Obidike

Journal of Global Initiatives: Policy, Pedagogy, Perspective

This article identifies the survival needs of the forced migrant Nigerian child as well as the extent to which the identified needs are satisfied. The population consisted of 600 forced migrant children and 10 emergency workers who were chosen based on their experiences being forced migrants. A questionnaire was used for the study. The result showed) among other things, that although the need for food, clean water, education, peace, and shelter were identified as the five most essential needs, other needs were also identified as necessary for the children's survival. Based on the results, recommendations were made.

Medical-Legal Partnerships: Addressing The Unmet Legal Needs Of Health Center Patients, Peter Shin, Fraser Rothenberg Byrne, Emily Jones, Joel B. Teitelbaum, Lee Repasch, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Medical-legal partnerships (MLPs), now available at over 180 hospitals and health centers across 38 states, are an important option for addressing the legal needs affecting low-income and vulnerable patients, and thereby improving their overall health. We estimate that each year, anywhere between 50 and 85 percent of health centers users - or between ten and 17 million people - experience unmet legal needs, many of which negatively impact their health. In a medical-legal partnership, health care staff at hospitals, clinics, and other sites are trained to screen for health-related legal issues, refer the patient to an affiliated lawyer or legal …

Standardized Performance Measurement And Reporting In Emergency Departments (Eds), Gw Urgent Matters Learning Network Ii

Health Workforce Research Center Publications

The drive to maximize emergency department (ED) efficiency while also ensuring the quality of care they deliver has been the focus of experts in the United States for decades. Access to patient-centered and equitable emergency care is critical to a community, and EDs are the safety net that must provide that care whenever it is needed, to whomever needs it. A wellmanaged ED increases the quality and safety of patient care and strengthens the health care infrastructure.

Consumer Consent Options For Electronic Health Information Exchange: Policy Considerations And Analysis, Melissa M. Goldstein, Alison L. Rein

Health Policy and Management Faculty Publications

The issue of whether, to what extent, and how individuals should have the ability to exercise control over their health information represents one of the foremost policy challenges related to the electronic exchange of health information. The current landscape of possible consent models is varied, and the factors involved in choosing among them are complex. States and other entities engaged in facilitating the exchange of electronic health information are struggling with a host of challenges, chief among them the establishment of policies and procedures for patient participation in their exchange efforts. While some have adopted policies enabling patients to exercise …

Changing Po2licy: The Elements For Improving Childhood Asthma Outcomes, Anne Rossier Markus, Meagan Lyon, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Childhood asthma is a serious and chronic health issue that affects one in seven U.S. children and their families, compromising their health and quality of life and placing a heavy financial burden on families as well as an enormous strain on the health care system. Treating, managing, and ultimately preventing and reducing the burden of asthma represents a critical test of the ability of the U.S. health system – health insurers, clinical care providers, and public health agencies – to work together. Our investigation found that, as a country, we already know enough to act and improve life for the …

Conceptions Regarding Children’S Health: An Examination Of Ethnotheories In A Sending And Receiving Community, Maria Rosario De Guzman, Jennifer Deleon, Gloria Gonzalez-Kruger, Rodrigo Cantarero

Department of Child, Youth, and Family Studies: Faculty Publications

Ethnotheories are beliefs that adults hold about children and the factors that impact upon their development. Scholars suggest that “ethnotheories” serve as cultural models that underlie motivations for parenting practices and the way adults organize children’s early experiences. This study examines Mexican adults’ ethnotheories about children’s health in two communities that are linked by transnational migrants and serve as sending and receiving communities for workers. Forty-four Mexican adults in six focus groups discussed well-being issues affecting children in their communities. Qualitative analyses using grounded theory revealed a complex conception of children’s health issues that included physical, psychological, and behavioral components …

The President's Emergency Plan For Aids Relief (Pepfar): A Social Work Ethical Analysis And Recommendations, Robert J. Barney, Stephan L. Buckingham, Judith M. Friedrich, Lisa M. Johnson, Michael A. Robinson, Bibhuti K. Sar

The Journal of Sociology & Social Welfare

The President's Emergency Plan for AIDS Relief (PEPFAR) is the most recent international social program instituted by the U.S. Government to combat HIV/AIDS. Since its inception in 2003, this foreign policy initiative has dedicated $63 billion for HIV/AIDS prevention and treatment in foreign countries. Despite PEPFAR's many accomplishments, it continues to promote controversial prevention strategies. This paper analyzes these prevention strategies, utilizing social work values as described in the NASW Code of Ethics. Policy, practice, and research implications are discussed.

The Economic Stimulus: Gauging The Early Effects Of Arra Funding On Health Centers And Medically Underserved Populations And Communities, Peter Shin, Brian K. Bruen, Emily Jones, Leighton C. Ku, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

During times of economic crisis, community health centers and other health care safety net providers become even more vital to the communities they serve. The current downturn, with its high levels of unemployment and enormous impact on family incomes, carries major implications for health insurance coverage. The American Recovery and Reinvestment Act (ARRA), signed into law on February 17, 2009, provided slightly more than two billion dollars to community health centers for capital improvements, expansion (or retention) of personnel and services, and adoption of health information technology. All of these uses not only support health centers' mission to serve populations …

Traveling Exhibit: The Lives They Left Behind: Suitcases From A State Hospital Attic, Laura J. Hall

Posters and Presentations

The Lives They Left Behind: Suitcases from a State Hospital Attic was a traveling exhibit that explored the stories of patients from the Willard Psychiatric Center in New York, whose personal belongings were discovered after the institution closed in 1995. The exhibit highlighted the intersection of mental health, poverty, and systemic failures in care. Through a series of public events including panel discussions on homelessness, health equity, and mental health policy, the exhibit aimed to raise awareness and promote dialogue on mental health issues. Curated locally by Laura J. Hall and funded by the New Mexico Humanities Council, it was …

Risky Business: Effectiveness Of State Market-Based Health Programs, Christopher Stream, Nathan Myers

Public Policy and Leadership Faculty Research

Since the 1990s, state governments have been leaders of health care reform. Today, approximately 47 million people are without health insurance. As health care costs and uninsurance levels continue to rise, states are pursuing a variety of government- and market-based strategies to address this growing social problem. Health care research has indicated that state-based programs have proven to be successful in extending access to coverage. However, the question remains as to whether the market-based programs have had a positive impact on state health care. Advocates for market-based state health programs argue that the reforms benefit the greater good because they …

The Intersection Of Public Policy And Health Behavior Theory In The Physical Activity Arena, Genevieve Dunton, Michael Cousineau, Kim D. Reynolds

CGU Faculty Publications and Research

Background:

Policy strategies aimed at modifying aspects of the social, physical, economic, and educational environments have been proposed as potential solutions to the growing problem of physical inactivity. To develop effective physical activity policies in these and other areas, greater understanding of how and why policies successfully impact behavior change is needed.

Methods:

The current paper proposes a conceptual framework explaining how policy strategies map onto health behavior theoretical variables and processes thought to lead to physical activity change. This framework is used to make hypotheses about the potential effectiveness of different policy strategies.

Results:

Health behavior theories suggest that …

Uncompensated Care And Quality Assurance Among Rural Hospitals, Doohee Lee, Chris Dixon, Paul Kruszynski, Alberto Coustasse

Management Faculty Research

Health care disparities in rural areas remain significant in the U.S. health care industry. Uncompensated care makes health care disparities in rural areas worse, and rural hospitals are unfavorably positioned to compete with urban hospitals in the economic-downturn marketplace. How uncompensated care affects quality care among rural hospitals has been lightly investigated. Given that many rural residents experience difficulty accessing high quality care and given the importance of establishing quality care practice standards in a rural setting, we conducted a systematic literature review to identify some quality-care barriers and opportunities and suggested strategies to strengthen the position of rural hospitals …

Increasing Institutional Delivery And Access To Emergency Obstetric Care Services In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative in rural Uttar Pradesh (UP), India to determine the impact of the Janani Suraksha Yojana (JSY) scheme on the current status of institutional delivery in the region, to understand the facilitating factors and barriers in delivering in a health facility, and to identify programmatic and behavior change communication (BCC) initiatives that could accelerate the adoption of institutional delivery. JSY was launched as an intervention to address the barriers to institutional delivery, through the introduction of community-based women volunteers. The study shows that with the introduction of the JSY the rate of institutional delivery jumped …

Referral Mechanism Improves Uptake Of Art Services For Hiv+ Fp Clients, Population Council

Reproductive Health

An operations research intervention by the Population Council in Kenya aimed to design a referral framework for linking HIV‐positive family planning (FP) clients to treatment and care in selected health facilities. The project also assessed the acceptability and effectiveness in increasing the number of eligible HIV‐positive FP clients receiving HIV care and treatment services. This summary details the effort to improve the linkage between FP services and comprehensive care centers that led to a dramatic increase in the proportions of HIV-positive clients in FP clinics who go on to receive HIV/AIDS treatment and care services at the same facility. Recommendations …

Snapshot 2010: Maine Workers With Disabilities, Maine’S Commission On Disability And Employment, Choices Ceo Project

Disability & Aging

No abstract provided.

The Relationship Between Obesity And Skin And Soft Tissue Infections, Juliana Swiney

MPA/MPP/MPFM Capstone Projects

The Problem:

It is well known that our country is experiencing an obesity epidemic: 33.9% of all adults are obese (BMI>30) and 67% of adults are either overweight or obese (BMI>25). Obesity is a risk factor for several serious disease states such as, diabetes, stroke, hypertension, heart disease and some types of cancer. It also has a less well defined relationship with skin and soft tissue infections.

Although it is known that excessive weight increases the opportunity for harmful skin conditions, this relationship has not been as well studied. Some of the mechanisms that predispose obese people to …

Données Démographiques Pour Développement Ii—De La Recherche À L'Intervention: Améliorer L'Accès Et L'Utilsation Des Données Par Les Médias, Population Council

Poverty, Gender, and Youth

This policy brief describes the Population Council’s project to improve access and use of demographic, health, and other public sector data that are essential evidence for development policy planning and evaluation. In many countries, access to data is limited and, when data are available, the format is rarely user-friendly for nonprofessionals, limiting their potential applications. In recent years, the Population Council has examined access to and sharing of data through case studies in Ethiopia, Ghana, Senegal, and Uganda. In phase II of the project, the Council will strive to promote domestic demand for data by working with key intermediaries—the media.

Guidelines For Pilot Study On Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn And Child Health Services In Bangladesh, Directorate General Of Health Services (Dghs), Population Council, Unicef

Reproductive Health

The Population Council launched a pilot study to test two Pay-for-Performance (P4P) strategies to improve MNCH services in Bangladesh. This document presents guidelines for offering incentives to providers, distributing coupons, and forming P4P and/or Coupon Committees and Quality Assurance Groups. The guidelines were developed over the course of five policy-level and consensus-building workshops with national and local-level program managers and service providers, organized under the leadership of the DGHS, in consideration of the local context and sustainability in case of nationwide replication in the country. These guidelines will come into effect upon receiving approval from the DGHS, Ministry of Health …

Role Of The Corporate Sector In Promoting Family Health In Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Confederation of Indian Industry, a partner in the Population Council–led Consortium, took the lead to explore a) the role of the corporate sector in family health in Uttar Pradesh, India; b) the possibility of partnering with this sector to design, leverage, and implement a behavior change communication (BCC) strategy; and c) the support and assistance the sector would require to ensure better planning and implementation of their corporate social responsibility (CSR) activities. Based on the findings, this policy brief identified the following, with implications for BCC strategy: corporate partnerships have the potential to scale up initiatives; companies can leverage …

Increasing Postpartum Contraception In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to assess the level of adoption of postpartum contraception for spacing among low parity women, identify the facilitating factors and barriers to the adoption of this target behavior, and identify programmatic and behavior change communications (BCC) initiatives that could accelerate the adoption of postpartum contraception for spacing and improve the service delivery system, if required, to facilitate the process. Barriers included low awareness of consequences of closely spaced births, misconceptions about contraceptive methods, lack of counseling by health workers, reluctance to include husbands, and programmatic emphasis on limiting …

Une Stratégie Pour La Réduction De La Mortalité Maternelle Et Néonatale, Population Council

Reproductive Health

As part of the strategies to reduce maternal and neonatal mortality, the introduction of a minimum integrated package of maternal and newborn care including Active Management of the Third Stage of Labor (AMTSL) and Essential Newborn Care (ENC) are simple and inexpensive approaches in poor countries. This brief reports on a study conducted by the Senegal Ministry of Health and Prevention, with support from IntraHealth and the Population Council, whose objectives included: 1) evaluating the functional capacity of the targeted health structures to offer the AMTSL and ENC, 2) evaluating the knowledge and skills of the providers, and 3) identifying …

Private Sector's Role In Health Service Provision In Senegal, Population Council

Reproductive Health

In Senegal, private providers are a major source of health services, including contraceptive services, and private sector partnerships are a key component of the Ministry of Health strategy toward achieving national health objectives. This brief reports on SMNI/PF/PALU—a five-year USAID-bilateral project aiming to foster high-quality service delivery, and build strong links between all levels of the health system and communities, including between private and public health sectors. In Senegal, private businesses have hosted innovative advocacy activities, committed to health supplies and information management, and demonstrated a general interest in supporting a collaborative movement toward national health objectives. With private sector’s …

Rôle Du Secteur Privé Dans L'Offre De Services De Santé Au Sénégal, Population Council

Reproductive Health

In Senegal, private providers are a major source of health services, including contraceptive services, and private sector partnerships are a key component of the Ministry of Health strategy toward achieving national health objectives. This brief reports on SMNI/PF/PALU—a five-year USAID-bilateral project aiming to foster high-quality service delivery, and build strong links between all levels of the health system and communities, including between private and public health sectors. In Senegal, private businesses have hosted innovative advocacy activities, committed to health supplies and information management, and demonstrated a general interest in supporting a collaborative movement toward national health objectives. With private sector’s …

Proceedings And Presentations From The Free State Child Abuse Indaba, Population Council

Reproductive Health

The Free State Department of Health and its partners held a “first-of-its kind” Child Sexual Assault Indaba (conference) in South Africa to streamline relationships between services for effective prevention and management of child abuse. This report details the presentations delivered at the conference, which was a resounding success, with participation from a wide range of stakeholders. The recurring theme of all the presentations was the urgent need to unite and fight against child sexual assault. The most appropriate strategy was unanimous—information—and clarity in terms of the role of each stakeholder. The Free State Department of Health will coordinate the development …

Mainstreaming Emergency Contraception Pills In Kenya, Jill Keesbury, Monica Wanjiru, Katherine Maina

Reproductive Health

To improve access to emergency contraception (ECP) and ensure that adequate information is provided to all users, the Kenyan Ministry of Public Health and Sanitation, the Population Council, and Population Services International-Kenya undertook a three-year effort to mainstream ECP in Kenya. This brief presents the results of this initiative and discusses strategies for further strengthening ECP provision. Kenya has emerged as a leader in ECP programming in the region and has demonstrated that it is possible to strengthen ECP services in both the public and private sectors while at the same time increasing public awareness, knowledge, and use of the …