Health Policy Commons^™

Where Do We Go From Here?: Two Key Informants' Perspectives On How To Address Conscientious Objection In Top Provision In South Africa, Talia Parker

Independent Study Project (ISP) Collection

This perspectives research endeavor examines the barriers to TOP access that arise from conscientious objection through the conflicting network of rights and legislation in South Africa. While previous research has evidenced the demonstrable barriers to accessing TOP care in South Africa, this project aims to push the existing literature and the field as a whole one step further to interrogate how to move forward within the realities of conscientious objection.

To do so, I conducted interviews with key informants in the field of reproductive healthcare provision, research, and activism in Cape Town on their perspectives about the practice of conscientious …

Z4, A Slow Puncture: An Autoethnographic Exploration Of Language, Embodiment, And Meaning-Making, Charlotte Rose Samuels

Independent Study Project (ISP) Collection

In my ISP, I explored language as it relates to the ways in which people living in Cato Manor make sense of HIV/AIDS in their community. With 7.1-7.2 million people living with HIV (PLWHIV) in South Africa, individuals across the country are either infected or affected by illness. KwaZulu-Natal (KZN), the province with the highest rate of HIV, is also the province that was surveyed with the disproportionately highest internal stigma rates for PLWHIV. High prevalence of HIV, particularly in KZN, calls for a constant contextualization of life in the presence of illness.

Throughout the world, metaphor and symbolism is …

From The American People: An Autoethnographic Exploration Of South African Ngos' Perceptions Of Pepfar, Antonia Asher

Independent Study Project (ISP) Collection

The aim of this research was to understand what the ideal partnership would be between United States (US) governmental aid agencies and South African non-governmental organizations (NGOs), specifically concerning HIV/AIDS programs funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR), from the perspective of NGOs. PEPFAR is the largest relief fund for a single disease; thus, I additionally sought to deeply reflect upon myself as a US citizen in South Africa, a country that has received trillions of dollars from taxpayers such as myself.

To accomplish this, I interviewed NGO staff about the nature of current partnerships, outcomes …

Characterizing Systems Of Reporting And Mitigating Anthrax Outbreaks Near Mto Wa Mbu, Monduli District, Tanzania, Megan Levy

Independent Study Project (ISP) Collection

Northern Tanzania has experienced several anthrax outbreaks in the recent past. In Monduli district, an outbreak in 2016 prompted an organization of district officials to create an updated outbreak response action plan. The pastoralist community is often affected by these outbreaks due to their frequent direct contact with cattle and herds’ proximity to wild species potentially affected by the disease. This characterization of the existing systems of reporting and mitigating anthrax outbreaks was accomplished through structured interviews with ward and village officers, local veterinarians, and members of the pastoralist community in Monduli district near Mto wa Mbu. The purpose of …

Vaccine Hesitancy In The United States And Switzerland, Anna E. Lunderberg

Independent Study Project (ISP) Collection

Vaccine hesitancy (VH), or the reluctance or refusal to participate in vaccination programs, is a complex phenomenon with far-reaching impacts on society. VH can impact vaccine uptake and facilitate subsequent outbreaks, as seen with the case of measles. Perceptions of vaccination are similar in the United States and Switzerland, and misinformation in each country contributed to VH through impaired parental risk-benefit analysis; parental analysis and subsequent VH is associated with both anti-vaccination messages gaining prominence and a decrease in the public perception of the health risk from vaccine-preventable diseases (VPDs). There are many proposed strategies for addressing VH on both …

Cancer Management In Kenya - Awareness And The Struggles Patients Face To Access Treatment, Care & Support, Ashley Nmoh

Independent Study Project (ISP) Collection

The amount of cancer cases in Africa, and Kenya specifically, are rising at an alarming rate. This study was conducted to determine the challenges that patients with cancer in Kenya face to access treatment, care and support. Thirty-nine cancer patients were interviewed and thirty cancer patients filled out a questionnaire about their experiences of having cancer in Kenya. In addition, twenty key informants were interviewed including doctors, caregivers, cancer NGO executives, a researcher, a psychologist, a National Health Insurance Fund official and a director from the Ministry of Health. A breast cancer awareness survey was also administered to fifty-nine women …

Nationalizing Services For The Trans-National: How Sub-Saharan Migrants Navigate Healthcare Access In Tunisia, Batoul Hasan

Independent Study Project (ISP) Collection

The right to human health and the resources that empower this state is an entitlement recognized under international law. With the circumstances surrounding their journeys, migrants face increased risks and vulnerabilities that necessitate social protections. Nations of reception, due to exclusionary policies or lack of capacity, may fail to guarantee these protections. This study investigates how this phenomenon unfolds in Tunisia, a middle-income nation undergoing a host of political and economic changes, but one that’s nonetheless become an alluring destination for migrants, specifically those from sub-Saharan African nations. The analysis proceeds from an assessment of the public health situation in …

Exploring Mobility Help-Seeking Behavior Among People With Physical Disabilities: A Case Study Of Jaipur Foot, Alex Podell

Independent Study Project (ISP) Collection

It is estimated that as many as 90 million people living in India experience some sort of disability (The World Bank, 2007). As India’s population keeps growing and aging, not only will the medical aspects, but also the societal impacts of disability need to be brought to the forefront of discussion, developmental strategy, and policy implementation. This study sought to analyze factors influencing the process of seeking help from formal and informal sources for people with physical disabilities. Data was collected from 10 people with physical disabilities receiving a variety of mobility aids from the NGO, Bhagwan Mahaveer Viklang Sahayata …

El Rol De Los Agentes Sanitarios Para Mejorar El Acceso A La Salud Sexual Y Reproductiva Para Mujeres En San Carlos, Mendoza. / The Role Of Agentes Sanitarios In Improving Access To Sexual And Reproductive Health For Women In San Carlos, Mendoza., Laura Hult

Independent Study Project (ISP) Collection

Introducción: Es evidente que Argentina tiene un enfoque que atiende a la salud sexual y reproductiva, dado que tiene cobertura universal y la ley de Programa Nacional de Salud Sexual y Procreación Responsable que establece un estándar de cuidado para toda la población. Sin embargo, cobertura universal no implica acceso universal, el cual que está determinado por el transporte, el idioma y la cantidad de recursos de la región. En lugares como San Carlos, Mendoza, donde no hay transporte regular y hay pocos recursos, existe inequidad en la salud, lo que puede aumentar las tasas de embarazos no intencionales y …

Los Microcosmos De La Interculturalidad? Una Mirada Al Cómo Los Trabajadores De La Salud Biomédica De Orígen Indígena Relacionan Con Los Modelos De Salud Tradicional Y Occidental, Taylor Lord

Independent Study Project (ISP) Collection

Research Question: How does a biomedical health professional with indigenous roots in Chile relate the biomedical model of healthcare with the alternative indigenous model in their practice?

Objectives: The primary objective of this study was to understand how and if a biomedical health professional with indigenous roots relates and integrates two models of healthcare in their daily practice. A Secondary objective was analyzing if integration affects philosophy of care in relation to patients in critical conditions. In sum, it looked to study biomedical health professionals with indigenous roots as potential microcosms of interculturality that can demonstrate the benefits of a …

Is Technology The Key To Prevention Of Falls Among The Elderly In Rapidly Aging Societies? A Case Study Of Kunming, China, Phoebe Kiburi

Independent Study Project (ISP) Collection

As the aging society rapidly becomes more dominant in the world, there is a pressing need for different stakeholders to tend to the needs of the aging sufficiently. This is crucial in ensuring the robustness of the healthcare system as a whole; given that it can only be as strong as its weakest link. This study focuses on one of the areas of need of the ageing society: fall prevention.

Numerous studies have been done on interventions by the government, private entities, elderly people and their caregivers to prevent occurrence and recurrence of falls. However, most of these have been …

Health On The Move: Health-Seeking Behavior Of Changpa Nomads In Ladakh, India, Maya Lubeck-Schricker

Independent Study Project (ISP) Collection

The goal of this study is to understand the health-seeking behavior of Changpa nomads in the Changthang region of Ladakh, India including what health issues these communities face, what they do when they fall sick, any preventative health behavior they implement, as well as the health infrastructure available to them. Very little literature exists on the health seeking-behavior of people in South Asia in general, much less among nondominant lifestyles such as that of nomadic or semi-nomadic people. As such, this research hopes to move towards closing that knowledge gap by conducting and analyzing 26 in depth semi-structured interviews and …

La Incorporación De La Vacuna Contra Varicela Al Calendario Nacional De Vacunación En Argentina: ¿Cómo Se Llegó A Esta Política Pública? / The Addition Of A Varicella Vaccination To The Argentine National Calendar Of Vaccination: How Did This Public Policy Arise?, Ilana Olin

Independent Study Project (ISP) Collection

Este estudio de política pública describe la incorporación de la vacuna contra varicela al Calendario Nacional de Inmunizaciones en la Argentina analizando la política pública como un ciclo de acción. Usando un diseño exploratorio y cualitativo, este estudio intenta combinar las reflexiones de 6 expertos entrevistados involucrados directamente en este proceso político con unos estudios antecedentes y otras fuentes secundarias. Presenta una narrativa comprensiva, teniendo en cuenta la estructura de análisis proporcionado por el marco-conceptual. Los aspectos éticos considerados incluyen el anonimato de estos expertos, quienes firmaron un formulario de consentimiento informado describiendo los objetivos y limitaciones de esta investigación. …

Kisumu County Hospital Patient Demographic Analysis: Looking Toward Universal Health Coverage, Lauren Scheffey

Independent Study Project (ISP) Collection

Universal health coverage is priority sought after by developed and developing nations alike, and Kenya sits on the list of countries seeking to achieve this goal in the coming years. The definition of “coverage” can vary by country, but three criteria are commonly found in the discussion of UHC globally: access, affordability, and quality. Affordability is determined by the state’s healthcare financing system; quality refers to the services provided by health facilities; and access, at least in part, concerns the geographic placement of health services providers in relation to the population they intend to serve. This geographic element is the …

Surveying Access To Healthcare In Kisumu And Siaya Counties, Kenya, Quinn Alsheimer

Independent Study Project (ISP) Collection

This study aims to understand the barriers that many Kenyans face towards accessing healthcare. This study was conducted in Kisumu and Siaya Counties, Kenya. Kisumu is an urban environment, whereas Siaya is a rural environment. Throughout both counties, areas with presumably low access to healthcare were surveyed. In Kisumu County, surveys were conducted in three informal settlements: Nyalenda, Obunga, and Manyatta. In Siaya County, surveys were conducted in Simenya Village.

This study has shown that financial accessibility is a large barrier to healthcare throughout the study population, as the majority of study participants felt that healthcare in Kenya is not …

Participatory Development And Menstrual Health Management In South Africa: A Case Study Of Project Dignity, Natalie Geismar

Independent Study Project (ISP) Collection

Menstrual health management (MHM) poses a significant public health concern in many South African communities. Though the national government is beginning to devote attention and resources to MHM, civil society organizations play a critical role in providing menstrual health products and education to female-bodied individuals who may otherwise lack access. This study examines the praxis and impact of Project Dignity, a nongovernmental organization which distributes washable, reusable sanitary pads and panties to students in public schools. The researcher collected qualitative data through participant observation as well as interviews and focus group discussions with Project Dignity’s staff and intended beneficiaries. Using …

When The Health System Fails You: Maternal Care Under Kenya’S 2017 Nurses' Strike, Tessa Coughtrey-Davenport

Independent Study Project (ISP) Collection

This study focuses on the 2017 nurses’ strike and how the crippling of the public health system impacted maternal care in Kisumu, Kenya. Kenya has one of the highest maternal mortality ratios in the world, and there have been many efforts to reduce this, such as delivery with a Skilled Birth Attendant and attending antenatal care visits, all of which are centered around a functioning health system. The research team used a combination of interviews with key populations and analysis of service delivery data at local health centers to evaluate the effects of the strike on maternal care. The study …

Caring For Caregivers: Challenges Facing Informal Palliative Caregivers In Western Kenya, Hartlee Johnston

Independent Study Project (ISP) Collection

Chronic illnesses like cancer, HIV, and other non-communicable disease are increasing globally, especially in developing countries, necessitating development of palliative care and symptom management systems. In Kenya, the burden of care for chronically ill patients often falls to unpaid, informal caregivers like family members or friends. Thirty-five current or past informal caregivers from Kisumu, Kenya were interviewed about their experience, challenges they faced, and interventions they felt would be helpful. Major challenges identified included lack of finances for treatment and other living expenses; inadequate, unaffordable, or interrupted medical care; emotional stress exacerbated by juggling many responsibilities, pressure to emotionally support …

Community Perception Of The Hiv Vaccine In Western Kenya: Acceptability, Potential Behavior Changes, And Views On Compulsory Vaccination, Deborah Keen

Independent Study Project (ISP) Collection

Human Immunodeficiency Virus (HIV) suppresses the immune system by attacking T cells, leading to the development of acquired immunodeficiency syndrome (AIDS). HIV affects over 30 million people around the world and 1.6 million people in Kenya. On August 18, 1987, the FDA sanctioned the first human testing of a candidate vaccine for HIV. Currently, multiple HIV vaccines—projected to be on the market in five to ten years—are being tested for efficacy and safety. The goal of this study was to explore opinions related to the HIV vaccine so that there is a guide for future policy development in Western Kenya. …

The Latex Journey: A Narrative Approach To Exploring Condom Use, Stigma, And Education From The Perspective Of Women In Masxha, Kylie Yocum

Independent Study Project (ISP) Collection

Although the South African National Department of Health (NDOH) is spending increasing amounts of money on improving their HIV programs (including the rollout of new, scented condoms for their condom distribution program), the rates of condom use at last sexual encounter are declining. This inquiry focused on young women in the neighborhood of Masxha, Cato Manor, and their opinions surrounding how condoms are being used or misused, as well as the gender norms that perpetrate this (mis)use. This inquiry demonstrated the narratives of these young women on factors such as condom acquisition, gendered stigma, and condom education, including the Life …

Understanding Sanitation Preferences: An Exploratory Study In The Sirohi District Of Rajasthan, Karen Mac

Independent Study Project (ISP) Collection

Of all the countries in the world, India has the highest number of people practicing open defecation, causing adverse health outcomes from the unconfined spread of faecal matter. The Government of India is ambitiously aiming to end this practice through the construction of 12 million toilets by 2019, but historically, many toilets across India have gone unused. This study focused on understanding: (1) the reasons why people continue to openly defecate despite having toilets and (2) the requirements of a toilet that rural households would be willing to use. Along with 36 observations of household toilets, semi-structured group (n=8) and …

Women Of Leh Town, Ladakh: An Overview Of Perceptions Of Health, Health-Seeking Behaviors, And Access To Health Care, Sophia Marion

Independent Study Project (ISP) Collection

The following study seeks to investigate access to health care services and perceptions of health care among women residing in traditional farming communities around the Ladakh region, and to analyze perspectives on health, health-seeking behavior, and access to health care. This project was prompted by the fact that health care in this region is understudied. This study also focuses on marginalized communities including local women and immigrant women. Methods used for the collection of data were qualitative interviews conducted with 24 women, as well as an amchi worker, doctors, and informal and formal conversations with people from different nongovernmental Organizations …

When Knowledge Flows: A Case Study Of Village Health Workers’ Motivations In Jamkhed, Selaem Hadera

Independent Study Project (ISP) Collection

Across the field of global health, there have been many attempts to cater to the health needs of the most marginalized populations. Community health workers (CHWs) are individuals that live in the communities they serve and are typically low-­‐income women with little to no formal education. After a period of training by their program, they enter their communities equipped as a bridge between the community and the health system. Although CHWs do play a substantial role in health delivery and education, the structure of CHW programs varies widely, but a common characteristic of these programs is that the CHWs are …

Mental Illness Stigma, Socially Acceptable Treatment, And Barriers To Health, Frances Renee Gellert

Independent Study Project (ISP) Collection

This paper discusses the topic of mental illness stigma and treatment in Uganda as explored through internship in the Social Work Department at Butabika National Referral Mental Hospital. The objectives of this project were to complete a meaningful internship while exploring causes of mental illness in Uganda, contradictions between traditional and modern approaches to treatment, and the affect of stigma on mental well-being. The internship included a total of 120 hours at Butabika Hospital. Individual research using documentary and literature review methods accompanied the internship. Butabika Hospital did not consent to the completion of formal research at, so any conclusions …

A Review Of 57 Zone: A Social Media Network For Tb Consultation And Communication In Kunming, China, India Medaris

Independent Study Project (ISP) Collection

Yunnan, a predominantly agricultural province in southwest China, is a province with a high rate of both tuberculosis (TB) and multi-drug resistant tuberculosis (MDR TB), with nearly 25,000 cases of pulmonary TB reported each year. Former TB/MDR TB patients in Yunnan, with the support of Family Health International 360 NGO (FHI) are trying to combat this problem. They have created a social media network for TB consultation and communication, 57 Zone, where TB patients can talk about their medication, adverse drug effects, and nutrition and psychosocial concerns. The goal of this study was the look at what aspects of the …

The Disappearance Of Nyoman And Ketut, Laura Michelle Garvie

Independent Study Project (ISP) Collection

No abstract provided.

Water, Sanitation And Hygiene In Rwamwanja Refugee Settlement, Katelyn Bergl

Independent Study Project (ISP) Collection

No abstract provided.

Quality Of Water In Relation To Diarrheal Disease Incidence In Obunga, Tianna Herman

Independent Study Project (ISP) Collection

Kenyan cities are experiencing a serious dilemma in dealing with the large influx of people from rural parts of the country to the cities. Most people come to the city in pursuit of better opportunities and jobs. Rapid urban growth with little planning and preparation by the national and county governments has led to the development of informal settlements. These informal settlements are characterized by poor environmental conditions that predispose their residents for poor health conditions. Because of their illegal status, most residents of informal settlements in Kenya do not receive government services such as water, drainage, sewerage, and rubbish …

Identificando Los Limites Del Acceso A La Salud Reproductiva: Un Análisis Sobre Las Experiencias Vividas Por Las Mujeres Guaraníes Con Los Servicios De La Salud Reproductiva En La Villa 31 De Buenos Aires, Amelia Mitchell

Independent Study Project (ISP) Collection

In order to serve the ‘public’, public health services must be accessible to everyone, without discrimination based on race, gender, social class, or geographic location, among other facets of identity. Reproductive health services, in particular, are a key service that must be adequately supplied in order to guarantee the health and wellbeing of a population. Reproductive healthcare not only allows individuals to decide if and when they wish to have a child, it also contributes to cancer prevention and the detrimental effects of sexually transmitted diseases. This investigation examines the experiences of Guaraní women that live within “Villa 31” of …

Reframing Homelessness In Vermont: A Systemic Approach To Homelessness Policy Advocacy In Windham County Vermont, Scott Sharland

Capstone Collection

The Changeworks Committee of the Groundworks Collaborative was created in 2014 to implement advocacy that would build public support for long-term policy changes addressing the root causes of homelessness in Windham County Vermont. This research focused on the work of this committee, and posed the question: How does reframing homelessness as a systemic issue instead of an individual issue impact the public perception of the problem in Windham County, Vermont? I argue that reframing perceptions of homelessness as the result of systemic failure and not as a problem of individual choice is key to building public support for solutions. Additionally, …