Demography, Population, and Ecology Commons^™

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

Resilience And Community Response To Climate-Related Events: Case Studies From Four Countries, Aviva Klein Meyers, Karen Hardee

Reproductive Health

It is important for governments, aid organizations, and researchers to understand how developing communities respond to climate change and how their efforts can be improved within a framework of resilience thinking. This review explores the definition of resilience and, more specifically, community resilience and its components, then presents four case studies of community response to extreme weather events to illustrate community resilience in action. The review is intended to provide context for and inform more detailed exploration of community resilience in integrated programming (specifically, programming designed to improve health, environment, and population outcomes). It is also intended to capture references …

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

Reproductive Health

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

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

Reproductive Health

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

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

Reproductive Health

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

Uganda Retail Audit: Analysis And Report, The Evidence Project

Reproductive Health

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

An Evaluation Of The Effect Of Abortion Laws On The Timing Of Abortion, Elizabeth Fuentes

Dissertations and Theses

A record number of restrictive abortion laws, particularly those known as Targeted Regulation of Abortion Providers (TRAP), have been passed in US states in the past half-decade. TRAP laws differ from abortion laws that target patients, such as parental involvement and waiting period policies, because they are often expensive, difficult, or impossible for providers to comply with, resulting in the reduction or elimination of abortion services. This can result in farther travel to and higher costs of abortion services for patients; however, there are no studies assessing whether one consequence of reduced geographic accessibility of abortion services is delays in …

Breast-Cancer-Specific Mortality In Patients Treated Based On The 21-Gene Assay: A Seer Population-Based Study, Valentina I. Petkov, Dave P. Miller, Nadia Howlader, Nathan Gliner, Will Howe, Nicola Schussler, Kathleen Cronin, Frederick L. Baehner, Rosemary Cress, Dennis Deapen, Sally L. Glaser, Brenda Y. Hernandez, Charles F. Lynch, Lloyd Mueller, Ann G. Schwartz, Stephen M. Schwartz, Antoinette Stroup, Carol Sweeney, Thomas C. Tucker, Kevin C. Ward, Charles Wiggins, Xiao-Cheng Wu, Lynne Penberthy, Steven Shak

Markey Cancer Center Faculty Publications

The 21-gene Recurrence Score assay is validated to predict recurrence risk and chemotherapy benefit in hormone-receptor-positive (HR+) invasive breast cancer. To determine prospective breast-cancer-specific mortality (BCSM) outcomes by baseline Recurrence Score results and clinical covariates, the National Cancer Institute collaborated with Genomic Health and 14 population-based registries in the the Surveillance, Epidemiology, and End Results (SEER) Program to electronically supplement cancer surveillance data with Recurrence Score results. The prespecified primary analysis cohort was 40–84 years of age, and had node-negative, HR+, HER2-negative, nonmetastatic disease diagnosed between January 2004 and December 2011 in the entire SEER population, and Recurrence Score results …

The Relationship Between Food Insecurity And Weight In The United States, 2011 – 2014, Sebastián Villamizar-Santamaría

Center for Latin American, Caribbean, and Latino Studies

Introduction: This report examines the relation between weight and food insecurity in the United States between 2011 and 2014.

Methods: The data used in this report come from the Integrated Health Interview Services (IHIS) and its food security index. Weight is assessed by body mass index, and the population is divided into four weight groups based on body mass index ranges.

Results: First, food insecurity rates declined among the general population of Latinos between 2011 and 2014, however, food insecurity rates rose dramatically among underweight Latinos over that time period. Second, food insecurity rates were greatest among the obese and …

Demographic Profile, Geographic Distribution, Disability Prevalence, And Likelihood Of Being In-Poverty Amongst Grandparents Responsible For Grandchildren, Carlos Siordia, Mary E. Rauktis

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

Evidence-based research on Grandparents Responsible for Grandchildren (GRfG) continues to grow in recent decades. This brief report expands global knowledge on custodial grandparents by making use of a large data resource in the United States (US). The specific aim was to delineate the demographic profile, geographic distribution, and prevalence of specific-disabilities for the GRFG population in the US mainland. We also explore how demographic factors are associated with likelihood of being in-poverty. The analysis used data from the 2009-2013 American Community Survey (ACS) 5-year Public Use Microdata Sample (PUMS) file. The ACS is a nationally representative, yearly, statistical survey administered …

Predictors Of Quality Of Life For African American Women Who Assist Persons Who Receive Dialysis, Shaquita A. Starks

Theses and Dissertations (ETD)

The purpose of this predictive correlational study was to describe predictors of quality of life (QoL) for African American women who were caregivers of persons with end stage renal disease (ESRD). Five purposes, derived from a review of literature and conceptual model, guided this study. First, the study described the association between demographic factors (i.e., education, employment, age, marital status), and QoL. Second, the study explored the relationship between stress and QoL. Third, the study described the association between depressive symptoms and QoL. Fourth, the study described the association between family health/happiness and QoL. Fifth, the study described the extent …

Project Soar's Approach To Research Utilization, Project Soar

HIV and AIDS

Project SOAR (Supporting Operational AIDS Research) conducts operations research (OR) with the aim of producing a large, multi-faceted body of high-quality evidence that can guide the planning and implementation of programs and policies for HIV prevention, care, and treatment. OR provides the needed evidence to make sound policy and program decisions at national, subnational, and service-delivery levels by identifying practical solutions to challenges delivering program services. Translating OR findings into action at these levels requires two-way information exchange between people who can apply research findings and researchers. Project SOAR’s premise is that this exchange will bring about eventual use of …

Retrospective Review Of Task-Shifting Community-Based Programs Supporting Arv Treatment And Retention In Uganda, Sam Kalibala, Jerry Okal, Brady Zieman, Nrupa Jani, Lung Vu, Josephine Birungi, Stephen Okoboi, Jonathan Wangisi, Christine Nabiryo, Joanne Lyavala Okullu, Michael Etukoit, Lydia Buzaalirwa, Augustine Lubanga, Paul Kiyingi, Jonathan Ikapule, Syson Nakyeyune, Stephen Nakibinge, Penninah Lutung, Samuel Waliggo, Joseph Nsamba, Yashien Wamanga, Joseph Kamya, Robina Sentongo, Robert Yiga

HIV and AIDS

The purpose of this study was to examine examples of task-shifting programs in Uganda with the aim of generating data that could inform the development of task-shifting policies, guidelines, and practices. The overall purpose of the study was to contribute to the growing knowledge base about task-shifting by describing the service delivery approaches of three purposively selected major AIDS service organizations (ASOs) in Uganda that have adopted task-shifting. The study showed that in the three ASOs, almost all key tasks in antiretroviral therapy (ART), including determining eligibility, initiating ART, and dispensing antiretrovirals, can be feasibly shifted to lower-level cadres or …

Developing An Implementation Science Research Agenda To Improve The Treatment And Care Outcomes Among Adolescents Living With Hiv In Sub-Saharan Africa, Julie Denison, Audrey Pettifor, Lynne Mofenson, Deanna Kerrigan

HIV and AIDS

In February 2016, Project SOAR convened a Technical Advisory Network meeting, attended by more than 50 international and domestic thought leaders in adolescent HIV care research and a small group of youth from southern Africa who are living with HIV. To prepare the groundwork for the meeting, SOAR produced a background paper synthesizing the literature on HIV continuum of care outcomes among adolescents living with HIV (ALHIV) in sub-Saharan Africa, where most adolescent cases of HIV are concentrated. This report presents the findings from the literature review and highlights from the Technical Advisory Network meeting. The first section is a …

Strengthening Community-Based Services For Children And Families Affected By Hiv: An Evaluation Of The Zambia Family Program, Project Soar

HIV and AIDS

As the US President’s Emergency Plan for AIDS Relief (PEPFAR) pivots its focus to care and treatment, there is strong interest in learning to what extent community-based programs contribute to achieving the public health goals of getting people—including children and adolescents—tested, enrolled in care if infected, and adherent to treatment. This brief describes Project SOAR’s evaluation of the Zambia Family (ZAMFAM) program, which will generate critical evidence to help fill knowledge gaps. The evidence will also guide country and global decisionmakers in strengthening community-based services to better meet the care, support, and treatment needs of vulnerable children and their families.

Understanding Hiv-Related Vulnerabilities And Stigma Among Egyptian Youth, Nahla G. Abdel-Tawab, Doaa Oraby, Sally Saher, Sarah Ismail

Poverty, Gender, and Youth

The overall objective of this study is to provide an evidence-based description and interpretation of the HIV-related risks and vulnerabilities faced by different subgroups of youth in Egypt. The report is part of a six-country study that was conducted by the Population Council in Egypt, Kenya, Nigeria, Senegal, South Africa, and Uganda. The study examines social, economic, cultural, and legal factors that may contribute to youth’s increased vulnerability to HIV and documents the situation of the policy and programmatic responses. The study identified poverty, unemployment, delayed marriage, and gender inequality as examples of factors that increase young people’s risk-taking behavior …

Addressing Intimate Partner Violence And Power In Relationships In Hiv Testing Services: Results Of An Intervention Piloted In Nairobi, Kenya, Nicole Haberland, Charity Ndwiga, Katharine Mccarthy, Margaret Makanyengo, Rose Kosgei, Cecilia Choi, Julie Pulerwitz, Sam Kalibala

HIV and AIDS

The overarching goal of this study was to pilot an approach to HIV testing services (HTS) that addresses intimate partner violence (IPV) and sexual relationship power (SRP) inequalities, and explores the intervention’s potential for improving uptake and retention of antiretroviral therapy and prevention of mother-to-child transmission services. The project was implemented in Kenyatta National Hospital’s (KNH) antenatal care (ANC) clinic, and examined intermediate indicators of effect, as well as operational issues around incorporating attention to IPV in hospital procedures, especially in high-volume, high-need settings like KNH’s. The findings from this study suggest that providing some minimal IPV/SRP counseling to all …

An Integrated Peer Outreach And Clinic-Based Intervention To Improve The Sexual Health Of Young Men Who Have Sex With Men In Myanmar: A Link Up Evaluation, Population Council

HIV and AIDS

This brief describes an evaluation that assessed the impact of a peer-driven intervention for young men who have sex with men (MSM) in Myanmar, designed to improve the sexual health and rights of this marginalized community. The intervention and evaluation activities were conducted as part of Link Up, a global consortium led by the International HIV/AIDS Alliance aimed at improving sexual and reproductive health and rights among young vulnerable communities in Africa and Asia. In collaboration with the Burnet Institute, the Population Council–led evaluation study sought to assess whether the Link Up intervention improved sexual and health-seeking behaviors, and whether …

Impact Of Peer Education And On-Site Clinical Services For Female Sex Workers In Bangladesh Brothels: A Link Up Evaluation Study, Population Council

HIV and AIDS

This brief describes an evaluation of a brothel-based HIV and sexual and reproductive health and rights (SRHR) intervention that combined peer outreach with the provision of on-site clinical services in several Bangladesh brothels. The aim of this evaluation was to assess whether peer educator one-on-one or group sessions and on-site satellite clinics improved SRHR knowledge and behaviors among women who sell sex in three Bangladesh brothels. The study was conducted by the Population Council as part of the Link Up project, a global consortium led by the International HIV/AIDS Alliance aimed at improving the SRHR of young people. The findings …

Reducing Provider-Held Stigma And Improving Young Client Satisfaction In Bangladesh: Findings From A Link Up Evaluation, Population Council

HIV and AIDS

To address HIV stigma in Bangladesh, a training program was designed and evaluated among service providers as part of Link Up, a global project led by the International HIV/AIDS Alliance designed to improve the sexual and reproductive health and rights (SRHR) of young people. These trainings aimed at sensitizing healthcare providers to the needs and rights of young people at high risk of stigmatization—such as sex workers, sexual minorities, or young people who engage in premarital sex. The Population Council collaborated with Marie Stopes International Bangladesh (MSIB) to evaluate whether stigma-reduction trainings improved provider attitudes toward these young marginalized populations, …

Sexual And Reproductive Health And Rights Needs Of Young Men Who Live In The Streets In Dhaka City: A Link Up Exploratory Study, Population Council

HIV and AIDS

Under the Link Up project—a global consortium led by the International HIV/AIDS Alliance and supported by the Dutch Ministry of Foreign Affairs—the Population Council conducted an exploratory study of the HIV and sexual and reproductive health and rights (SRHR) needs of young men who live in the streets of Dhaka City, Bangladesh. The study investigated their knowledge, behaviors, needs, and service utilization related to HIV and SRHR. The findings elucidate the substantial vulnerabilities and risks faced by young men who live in the streets of Dhaka City, most notably in terms of sexual risk and physical violence. Participants reported very …

Using Peers To Improve Sexual And Reproductive Health And Rights Of Young People Living With Hiv In Uganda: Findings From A Link Up Evaluation, Population Council

HIV and AIDS

Link Up, a global consortium led by the International HIV/AIDS Alliance, sought to meet the immediate HIV care needs and also the broader sexual and reproductive health and rights (SRHR) for Ugandan young people living with HIV (YPLHIV), by creating linkages between comprehensive community- and facility-based HIV and SRHR services. In addition, Link Up delivered health education, counseling, and peer support tailored to the needs of YPLHIV in order to educate and empower them to recognize their rights, and feel confident in seeking health services. This brief presents findings from the Population Council’s evaluation of Link Up activities among YPLHIV …

Building Evidence To Guide Prep Introduction For Adolescent Girls And Young Women, Nanlesta Pilgrim, Sanyukta Mathur, Ann Gottert, Naomi Rutenberg, Julie Pulerwitz

HIV and AIDS

This document was developed by the Population Council, with support from the Bill & Melinda Gates Foundation, to provide DREAMS country teams with practical guidance on building evidence to guide pre-exposure prophylaxis (PrEP) introduction for adolescent girls and young women (AGYW). The primary audiences for this document are health policymakers and program planners who will be making decisions about how PrEP is introduced and the researchers who will assess AGYW’s specific needs and experiences. Our aim is to complement emerging global guidance on PrEP and ongoing work regarding delivery platforms, marketing, and policy and regulatory frameworks for PrEP introduction more …

How To Reduce Hiv Risk Among Adolescent Girls And Young Women In Sub-Saharan Africa? Implementation Science Around The Dreams Initiative, Population Council

HIV and AIDS

The Population Council, with funding from the Bill & Melinda Gates Foundation and the US Agency for International Development through Project SOAR, is leading the implementation science portfolio of the timely and innovative DREAMS partnership in 10 sub-Saharan countries, producing evidence to strengthen DREAMS activities and other community-based programming. The Council’s research focuses on how best to reach the most vulnerable adolescent girls and young women (AGYW) and their male partners and engage them in activities and services, and how to roll out pre-exposure prophylaxis (PrEP) for HIV prevention among AGYW. By examining these critical HIV prevention issues, the Council’s …

Impact Of A Community-Based, Hiv Intervention On Antiretroviral Treatment Retention And Adherence In Tanzania, Project Soar

HIV and AIDS

Project SOAR is contributing to the evidence base on community-based care models by conducting implementation research in Tanzania, a country where 1.5 million people are in need of HIV care services, and where clients eligible for antiretroviral therapy (ART) often drop out or are lost to follow up. While the country has a cadre of community-based HIV service (CBHS) providers, they remain largely informal. Project SOAR and its partners are evaluating a coordinated, integrated model in which CBHS providers deliver an enhanced service package to HIV-positive clients. The evaluation will advance understanding of the value of CBHS providers in improving …

Project Soar's Voluntary Medical Male Circumcision Portfolio, Project Soar

HIV and AIDS

Project SOAR has developed an extensive voluntary medical male circumcision (VMMC) portfolio to support multiple countries with data to make informed policy and programmatic decisions about VMMC that address their specific needs and environments. A critical component of this portfolio is research utilization. At the country level, Project SOAR seeks to generate data to support planning, implementing, and monitoring VMMC programs and increase access to and use of this data through user-friendly interfaces and dissemination strategies. Simultaneously, SOAR aims to advance VMMC as a vital prevention strategy by filling important data gaps in the global discourse around VMMC. This brief …

Barriers To Fistula Repair In Nigeria: A Formative Study, Population Council

Reproductive Health

A formative research study was conducted in Nigeria to better understand the barriers and enabling factors for fistula repair care delivery and access. This brief presents results from a literature review conducted to identify and understand the delays in accessing and receiving treatment and corresponding barriers, to document interventions that help to overcome barriers, and to specify gaps in the literature that require further research. The report concludes that women’s concern over healing and reintegration reflects their expectation that the holistic approach of hospitals will bring them back to normal life incorporating physical, sexual, psychosocial, and economic rehabilitation. Awareness, financial, …

Strengthening Factory Health Systems Under Levi Strauss & Co.'S Worker Well-Being Initiative In Egypt, Population Council, The Evidence Project

Reproductive Health

The pilot intervention described in this brief took place at an apparel manufacturing company, Lotus, located in Port Said, Egypt as part of the Worker Well-being Initiative. Worker Well-being is an initiative of Levi Strauss & Co. and the Levi Strauss Foundation that seeks to move beyond a “do no harm” compliance model of labor rights in its global supply chain. The interventions in Egypt have contributed to the overall development of a health system–strengthening approach to private workplaces, which is a new concept for management. The work in Egypt contributed to a collaboration between the Evidence Project/RAISE Health and …