Demography, Population, and Ecology Commons^™

Introduction Of Dmpa-Sc Self-Injection In Ghana: A Feasibility And Acceptability Study Using Sayana® Press, Dela Nai, Patrick Aboagye, Kamil Fuseini, Elizabeth Tobey, Aparna Jain, Nora Maresh, Rebecca Fertziger

Reproductive Health

This research report describes results from an implementation science study that explored the feasibility and acceptability of administering depot medroxyprogesterone acetate-subcutaneous (DMPA-SC) among health-care providers and family planning (FP) clients in Ghana. DMPA-SC is an injectable contraceptive method that can be self-administered. The study, conducted by the Population Council through the USAID-funded Evidence Project in collaboration with the Ghana Health Service, was implemented in rural, peri-urban, and urban areas of the Ashanti and Volta regions. A total of 150 health-care providers were trained to administer DMPA-SC and to train clients on self-injection. Clients assessed as being competent self-injected under the …

Reflections From Five Years Of Research On Fgm/C, Lori S. Ashford, Reshma Naik, Charlotte Greenbaum

Reproductive Health

From 2015 to 2019, the Evidence to End FGM/C research consortium took a fresh approach to examining the longstanding practice of female genital mutilation/cutting (FGM/C). The African-led program developed innovative research methods and uncovered new evidence about the practice and how it is changing—focusing on families and communities, and health and legal systems. This report documents the consortium’s research methods, the key lessons learned, capacity strengthening efforts, enhanced advocacy for research uptake, and recommendations. The research sheds light on key areas for future investments that would ensure that FGM/C policies and programs are informed by rigorous evidence. The recommendations stem …

Understanding Local Variation In How Female Genital Mutilation/Cutting Declines, Changes, Or Persists: Analysis Of Household Survey Data For Kenya, Nigeria, And Senegal, Population Reference Bureau

Reproductive Health

Efforts to eliminate female genital mutilation/cutting (FGM/C) intensified in many parts of Africa following a 2012 United Nations General Assembly Resolution, but change has been uneven. Important evidence gaps remain in our understanding of why the practice declines, changes, or persists in specific locations. Policymakers and program planners need such information to better tailor interventions to address local patterns and focus resources on abandonment efforts in areas with the greatest needs. To fill these gaps, researchers with the Evidence to End FGM/C consortium analyzed nationally representative household survey data for Kenya, Nigeria, and Senegal. The results of their research identify …

Female Genital Mutilation/Cutting In Nigeria: Is The Practice Declining? A Descriptive Analysis Of Successive Demographic And Health Surveys And Multiple Indicator Cluster Surveys (2003–2017), Ngianga-Bakwin Kandala, Glory Atilola, Chibuzor Christopher Nnanatu, Emmanuel Ogundimu, Lubanzadio Mavatikua, Paul Komba, Zhuzhi Moore, Dennis Matanda

Reproductive Health

This report gives insight into the scale and scope of the practice of female genital mutilation/cutting (FGM/C) among women aged 15–49 years and girls younger than 15 years in Nigeria. It also presents evidence on where FGM/C occurs and highlights the dynamics of change as well as the context surrounding the practice. The report explores in detail the practice of FGM/C from all available sources of nationally representative survey data from 2003 to 2017 and the most relevant contextual information on key factors associated over time with FGM/C. The ultimate objective of the report is to generate evidence to inform …

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 …

A Population-Based Investigation Of Health-Care Needs And Preferences In American Adults With Multiple Sclerosis, Chungyi Chiu, Malachy Bishop, Bradley Mcdaniels, Byung-Jin Kim, Lebogang Tiro

Early Childhood, Special Education, and Counselor Education Faculty Publications

Background: Comprehensive and effective multiple sclerosis (MS) health care requires understanding of patients’ needs, preferences, and priorities. Objective: To evaluate priorities of patients with MS for their MS care. Methods: Participants included 3003 Americans with MS recruited through the National MS Society and the North American Research Committee on Multiple Sclerosis patient registry. Participants completed a comprehensive questionnaire on aspects of their health-care experiences. Results: Participants identified the top 3 health-care priorities as (1) the affordability of MS health care, (2) ensuring that non-MS health-care providers have more education about MS and how it can interact with other conditions, and …

Associations Between Female Genital Mutilation/Cutting And Early/Child Marriage: A Multi-Country Dhs/Mics Analysis, Jamlick Karumbi, David Gathara

Reproductive Health

Over the last several decades, global efforts to end female genital mutilation/cutting (FGM/C) have intensified through the combined efforts of international and nongovernmental organizations (NGOs), governments, and religious and civil society groups. Evidence of the wider impacts of FGM/C and interventions for its abandonment is small but emerging. The practice of FGM/C has frequently been linked to a girl’s marriageability and is thought to be associated with child marriage, either directly, as a cause of early/child marriage, or vice versa, or indirectly, resulting from common causes. Evidence of the relationships between these two practices to inform programming and policy for …

Modelling And Mapping Of Regional Disparities Associated With Female Genital Mutilation/Cutting Prevalence Among Girls Aged 0–14 Years In Senegal: Evidence From Senegal (Sdhs) Surveys 2005–2017, Ngianga-Bakwin Kandala, Paul Komba, Chibuzor Christopher Nnanatu, Glory Atilola, Lubanzadio Mavatikua, Zhuzhi Moore, Dennis Matanda

Reproductive Health

Between 2005 and 2017, Senegal experienced a slight national decline in the prevalence of female genital mutilation/cutting (FGM/C) among women aged 15–49 years and girls younger than 15 years. However, significant differences in prevalence exist as a result of multifarious risk factors. Our previous research in Senegal described the national trends in FGM/C, showing where, when, and why FGM/C is practiced in Senegal. However, no recent study exists to analyze the geographical patterns of FGM/C and the effect of individual-and community-level risk factors on the likelihood of cutting among girls younger than 15 years. This working paper presents results from …

Modelling And Mapping Of State Disparities Associated With Female Genital Mutilation/Cutting Prevalence Among Girls Aged 0–14 Years In Nigeria: Evidence From Dhs And Mics 2003–2017, Ngianga-Bakwin Kandala, Paul Komba, Chibuzor Christopher Nnanatu, Glory Atilola, Lubanzadio Mavatikua, Zhuzhi Moore, Dennis Matanda

Reproductive Health

The practice of female genital mutilation/cutting (FGM/C) has been positioned as a gender and global development issue that national and international organizations must address for girls and women to thrive in good health and enjoy their fundamental rights. Consequently, many efforts have been made to promote the abandonment of the practice. Despite evidence of a decline in FGM/C, there are significant variations in its prevalence in many sub-Saharan African countries, where the practice persists due to the combined effects of factors among individuals as well as communities. This working paper presents findings from a study that analyzed existing data using …

Population Council Annual Evaluation Report: Opening Futures (Abriendo Futuros) For Indigenous Girls In Yucatan, Mexico, Silvana Larrea

Poverty, Gender, and Youth

This Population Council Annual Evaluation Report includes evaluation activities from December 1, 2015 to December 1, 2019, and future evaluation plans (2019–21), as part of the Opening Futures (Abriendo Futuros) project for indigenous girls in Yucatan, Mexico. The first section describes the finalized analysis of the impact evaluation of the pilot phase; the second section reports the progress of evaluation activities; and the third section includes an evaluation of future plans for the period December 1, 2019 to November 30, 2021.

Decomposing Trends In Child Obesity, Ashley Wendell Kranjac, Robert L. Wagmiller

Sociology Faculty Articles and Research

We unravel the absolute level and relative prominence of two demographic processes that are relevant for childhood obesity, and that will ultimately determine the long-term course and pace of change in child obesity rates. We leverage data from the National Health and Nutrition Examination Survey to decompose change in child obesity from 1971 to 2012. We partition change into that attributable to (1) healthier, more nutritionally and economically advantaged cohorts in the population being replaced by cohorts of children who are less advantaged (between-cohort change), and (2) the health habits, nutrition, and social and economic circumstances of all cohorts of …

Prevalence And Correlates Of Diagnosed And Undiagnosed Hypertension In The Indigenous Kuna Population Of Panamá, Daniel R. Hanna, Rebekah J. Walker, Brittany L. Smalls, Jennifer A. Campbell, Aprill Z. Dawson, Leonard E. Egede

Center for Health Services Research Faculty Publications

Background: To determine the prevalence of hypertension and investigate sociodemographic correlates in an indigenous Kuna community living on the San Blas islands of Panama.

Methods: Data was collected from adults using a paper-based survey using a cross sectional study design. Blood pressure was measured, and hypertension defined at two cut-points: 130/80 mmHg and 140/90 mmHg. Individuals with undiagnosed hypertension had a blood pressure measurement that indicated hypertension, however, the individual had not been told by a doctor they had hypertension. Whereas individuals with diagnosed hypertension had been told by a healthcare provider that they had hypertension. Univariate tests compared diagnosed …

There Are Multiple And Geographically Distinct Opioid Crises In The U.S., Shannon M. Monnat

Population Health Research Brief Series

Rates of fatal drug overdose increased 250% in the U.S. between 1999 and 2017, due in large part to a massive surge in overdoses involving opioids. However, there is substantial geographic variation in fatal opioid overdoses, and prescription opioids, heroin, and fentanyl are differentially responsible for high overdose rates across different parts of the U.S. This research brief summarizes the findings from a study just published in the American Journal of Public Health. The study shows that there are at least four geographically distinct opioid overdose crises in the U.S.

Food Insecurity Among South Asian Immigrant Communities In The Inland Empire Of Southern California, Farhan Danish

Electronic Theses, Projects, and Dissertations

Background: Food insecurity amongst South Asian Americans is a major public health issue. The South Asian American (SAA) community is the third largest Asian community in the United States. Despite this fact, very few specific studies have been conducted to investigate the food needs and barriers that exist within the SAA community so as to successfully help them improve dietary habits.

Methods: This study utilized a mixed methods convergent parallel design, where both qualitative and quantitative methods were conducted and analyzed separately and compared and contrasted at the end.

Results: The results of this study demonstrate that ethnic grocery stores …

Watering Black Roots: Exploring Black Ecological Identity Development Within Nature-Based Expressive Arts Therapy, Stormy Saint-Val

Expressive Therapies Capstone Theses

Nature-based expressive arts therapy promotes the holistic healing and recovery of individuals by interweaving the practices of ecopsychology, ecotherapy, and expressive arts therapy. These interventions have been proven to mediate ranges of symptomologies, such as anxiety disorders and PTSD. Research conducted by the U.S. National Park Services indicates that African- Americans are less likely to have a positive relationship to nature than all other racial groups. The amplification of this report without introspection of its context perpetuates racialized generalizations. This can limit a black individual’s ability to embrace their ecological identity and be receptive of nature-based expressive arts therapy interventions. …

Education As Important Predictor For Successful Employment In Adults With Congenital Heart Disease Worldwide., Maayke Sluman, Maayke Sluman, Silke Apers, Judith Sluiter, Karen Nieuwenhuijsen, Philip Moons, Philip Moons, Koen Luyckx, Koen Luyckx, Adrienne Kovacs, Adrienne Kovacs, Corina Thomet, Werner Budts, Junko Enomoto, Hsiao-Ling Yang, Jamie Jackson, Paul Khairy, Stephen Cook, Raghavan Subramanyan, Luis Alday, Katrine Eriksen, Mikael Dellborg, Mikael Dellborg, Malin Berghammer, Malin Berghammer, Eva Mattsson, Andrew Mackie, Samuel Menahem, Maryanne Caruana, Kathy Gosney, Alexandra Soufi, Susan Fernandes, Kamila White, Edward Callus, Shelby Kutty, Berto Bouma, Barbara Mulder

Psychology Faculty Works

Background: Conflicting results have been reported regarding employment status and work ability in adults with congenital heart disease (CHD). Since this is an impor‐ tant determinant for quality of life, we assessed this in a large international adult CHD cohort. Methods: Data from 4028 adults with CHD (53% women) from 15 different countries were collected by a uniform survey in the cross‐sectional APPROACH International Study. Predictors for employment and work limitations were studied using general linear mixed models. Results: Median age was 32 years (IQR 25‐42) and 94% of patients had at least a high school degree. Overall employment rate …

Child Poverty, Physical & Mental Health In Maine, Katelyn Malloy

Thinking Matters Symposium Archive

Children who live below the national poverty line account for nearly one fifth of Maine’s overall population. Child poverty is a determinant of health that can lead to negative health outcomes that affect childhood development, educational achievement, as well as physical and mental health. The purpose of this study was to identify five Maine counties with the highest rates of child poverty according to the national average. Comparison of poverty rates between counties were analyzed along with two leading health indicators – mental and physical distress. This study used 2016 county-level childhood poverty estimates, assessed by the American Community Survey …

Meeting The Needs Of Orphans And Other Vulnerable Children: Learnings From Project Soar, Project Soar

HIV and AIDS

Orphans and other vulnerable children (OVC), including those living with HIV, often have a range of unmet needs, such as education, food security, psychosocial support, and access to health care. Project SOAR is documenting the unique vulnerabilities of OVC and their caregivers, and examining strategies to mitigate the impacts of HIV on them. This brief presents a summary of the SOAR portfolio, including a prospective cohort study of young people living with HIV in Zambia, an evaluation of an HIV risk screening tool among OVC in Tanzania, and a systematic review of promising interventions to support engagement and treatment adherence …

Providing Occupational Therapy To Those Who Are Homeless: A Beneficial Support, Francesca Petracco

Petersheim Academic Exposition

No abstract provided.

Strengthening Capacity To Prevent Hiv Among Adolescent Girls And Young Women: Supporting Dreams Programming, Project Soar

HIV and AIDS

The Population Council, with funding from Girl Effect, worked in seven Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) Partnership countries to strengthen the capacity of implementing partners to develop new approaches to reach AGYWs at highest risk of HIV infection, link them with essential resources, and empower them with social and protective assets for a safe and healthy entry into adulthood. This technical assistance was informed by the Population Council’s decades of research and experience determining “what works”—and what doesn’t work—in girl-centered programming. Through Project SOAR, the Population Council provided technical assistance to implementing partners in five additional countries …

Does Education Improve Health In Low- And Middle Income Countries? Results From A Systematic Review, Stephanie Psaki, Barbara Mensch, Erica Chuang, Andrea J. Melnikas

Poverty, Gender, and Youth

Despite enormous progress in expanding school enrollment globally, improvements in health have not always followed, raising important questions: Does education, in fact, enable women, men and their families to be healthier? And if so, how? To fill this gap in knowledge, the GIRL Center conducted a systematic review of the evidence for the effects of education on health in low- and middle-income countries.

Delivering Results In Girls' Education: How To Evaluate What Works, What Doesn't, And What We Don't Know, Stephanie Psaki

Poverty, Gender, and Youth

Girls around the world face daunting challenges when it comes to enrolling in primary school, completing secondary school, and gaining the basic knowledge and skills they need to be empowered, healthy, and productive adults. Many governments and organizations have risen to meet that challenge through policies and programs designed to remove common barriers to girls’ education. But as the number of actors in this space grows, and resources to address these challenges remain scarce, it is essential to ensure that investments are targeted toward the most effective policies and programs. This brief lays out the basics of program evaluation. The …

The Medicalisation Of Female Genital Mutilation/Cutting In Kenya: Perspectives Of Families And Health Care Providers, Population Council

Reproductive Health

This evidence brief summarizes key findings from a study that sought to understand the shifts in FGM/C including medicalization among several communities Kenya. The study finds that medicalization is increasing because: 1) it is perceived to be safer because the procedure is reportedly performed under sterile conditions by trained health professionals; 2) it is believed to shorten the recovery period; and 3) it is a response to the law prohibiting the practice because it allows FGM/C to be performed in secret. These findings indicate that medicalization is an adaptation to awareness of the health complications associated with FGM/C and the …

The Global Compact On Refugees: How The Sauti/Voice Project Fits, Josephine Ngebeh, Chi-Chi Undie, Joanina Karugaba

Reproductive Health

How can stakeholders support refugees in the present-day unprecedented global refugee crisis? At least one way is by entering into a clearly defined compact to do so. Developed in 2018, the Global Compact on Refugees is a nonbinding agreement among United Nations Member States and other relevant stakeholders, including international organizations. A symbol of political will, the Compact demonstrates the commitment of the international community to enhanced cooperation and solidarity with both refugees and their host communities. The Global Compact on Refugees provides the international community with guidance for supporting present-day refugee communities, characterized by large populations and protracted refugee …

Sauti/Voice Project: First Unhcr-Population Council Regional Workshop, Josephine Ngebeh, Chi-Chi Undie, Joanina Karugaba, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

In 2014, the UNHCR East and Horn of Africa and Great Lakes (EHAGL) Africa Bureau in Nairobi, and the Population Council/Nairobi established technical cooperation for Improving Evidence-based Programming for Sexual and Gender-based Violence (SGBV) in Refugee Operations in the East and Horn of Africa. The Africa Bureau works closely with the Council to initiate appropriate interventions for the prevention of, and response to, SGBV in refugee operations. The Council’s technical team is represented by the Council-led Africa Regional SGBV Network. Technical cooperation between the Africa Bureau and the Council has resulted in a new initiative: VOICE—Violence Prevention and Response Through …

Autonomy, Intimate Partner Violence, And Maternal Health-Seeking Behavior: Findings From Mixed-Methods Analysis In Kenya, Charlotte E. Warren, Pooja Sripad, Charity Ndwiga

Reproductive Health

Gendered norms and discriminatory practices often limit women’s decision-making power, which over time can lead to social norms that systematically disadvantage women. Aspects of empowerment were explored in a global evaluation of Demographic and Health Survey data that measured how gendered social norms influenced maternal health-seeking behaviors. Analysis specifically explored associations of women’s autonomy and acceptability of intimate partner violence against women (IPVAW) on antenatal care use and facility delivery in 63 low- and middle-income countries. Service utilization is positively associated with increased autonomy and negatively associated with increased acceptability of IPVAW, but variability exists across countries and regions. In …

« More Than Brides Alliance (Mtba) » : Rapport D’Évaluation À Mi-Parcours Au Mali Et Au Niger, Andrea J. Melnikas, Grace Saul, Mouhamadou Gueye, Aissa Diarra, Sajeda Amin

Poverty, Gender, and Youth

L’Alliance « Plus qu’une épouse » (More Than Brides Alliance—MTBA) a été formée, rassemblant les forces d’une équipe diversifiée, compétente pour la mise en œuvre et la recherche de programmes destinés aux adolescents. Le volet recherche de l’Alliance MTBA vise à fournir des preuves et des connaissances sur ce qui fonctionne pour retarder le mariage des enfants en Inde, au Malawi, au Mali, au Niger et au Pakistan en évaluant le programme d’intervention de l’Alliance MTBA et en examinant les facteurs spécifiques du mariage des enfants dans chaque contexte. Dans ce rapport, nous visons à évaluer les succès du programme …

The Girl Roster: A Practical Tool For Strengthening Girl-Centered Programming, Population Council

Poverty, Gender, and Youth

This brief describes the Girl Roster^TM, a practical tool designed by the Population Council to help practitioners understand their program areas and elicit foundational information to intentionally link girls—especially highly marginalized adolescent girls—to the vital resources, facilities, and services to which they are entitled but often have limited or no access. The tool is a user-friendly, efficient, and cost-effective way to collect program-relevant information about girls in a community, using a mobile phone–based questionnaire (or, where resources do not permit, paper and pencil). The tool enables users to see a fuller view of girls’ lived realities in defined …

Examining Early Marriage In India: Qualitative Findings, Neelanjana Pandey, Komal Saxena, Andrea J. Melnikas

Poverty, Gender, and Youth

The More Than Brides Alliance (MTBA) implements the “Marriage: No Child’s Play” program (2016–20) in India, Malawi, Mali, Niger, and Pakistan. The MTBA is a holistic program that addresses early marriage through multiple strategies, including: sexual and reproductive health and rights, livelihoods, education, and prevalent community social norms around marriage. Furthermore, the program operates at multiple levels (girl, family, community, block, and district) to address individual, familial, and structural barriers to reducing child marriage in these communities. This report first looks at the legal environment in which programs operate by examining participants’ awareness of laws, acts, and programs related to …