International Public Health Commons^™

Fgm/C Decision-Making Process And The Role Of Gender Power Relations In Sudan, Ahmed Gamal Eldin, Suad Babiker, Majdi Sabahelzain, Muna Eltayeb

Reproductive Health

This study by the Population Council, Nairobi and partners aimed to contribute to a better understanding of female genital mutilation/cutting (FGM/C) in Sudan and the way different families perceive the practice and make FGM/C-related decisions. The ultimate goal was to inform interventions aimed at accelerating the pace of positive behavioral and social norm change and eventually promote the abandonment of all forms of FGM/C in Sudan. The findings indicate that although parents often make the final decision to cut or not cut their daughters, they do not act in isolation but are influenced by dominant social norms and by other …

Findings From Post-Intervention Analysis Of Pre-Eclampsia/Eclampsia In Cross River State, Salisu Mohammed Ishaku

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal mortality. Following a landscape analysis to better understand the enormity of this problem across seven states in Nigeria, a cross-cutting intervention was implemented in Cross River, Ebonyi, and Kogi states. Researchers worked with primary healthcare (PHC) providers, policymakers, women’s groups, and community members to increase uptake of underutilized interventions and commodities for the prevention and treatment of PE/E in rural Nigeria. This brief presents study findings from Cross River State on post-intervention landscape changes in: programmatic …

Findings From Post-Intervention Analysis Of Pre-Eclampsia/Eclampsia In Ebonyi State, Salisu Mohammed Ishaku

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal mortality. Following a landscape analysis to better understand the enormity of this problem across seven states in Nigeria, a cross-cutting intervention was implemented in Cross River, Ebonyi, and Kogi states. Researchers worked with primary healthcare (PHC) providers, policymakers, women’s groups, and community members to increase uptake of underutilized interventions and commodities for the prevention and treatment of PE/E in rural Nigeria. This brief presents study findings from Ebonyi State on post-intervention landscape changes in: programmatic and …

Findings From Post-Intervention Analysis Of Pre-Eclampsia/Eclampsia In Kogi State, Salisu Mohammed Ishaku

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal mortality. Following a landscape analysis to better understand the enormity of this problem across seven states in Nigeria, a cross-cutting intervention was implemented in Cross River, Ebonyi, and Kogi states. Researchers worked with primary healthcare (PHC) providers, policymakers, women’s groups, and community members to increase uptake of underutilized interventions and commodities for the prevention and treatment of PE/E in rural Nigeria. This brief presents study findings from Kogi state on post-intervention landscape changes in: programmatic and …

Medicalisation Of Female Genital Mutilation/Cutting In Sudan: Shift In Types And Providers, Nafisa Bedri, Huda Sherfi, Ghada Rudwan, Sara Elhadi, Wafa Elamin

Reproductive Health

This study by the Population Council and the Gender and Reproductive Health and Rights Resource and Advocacy Center aimed to inform the development of future interventions by generating evidence on the drivers of the shifts in the practice of female genital cutting/mutilation (FGM/C) in Sudan. Researchers conducted a community-based cross-sectional, comparative, mixed-methods study that examined shifts in the type of cut, its level and significance, as well as the supply and demand factors associated with medicalization. They also explored interventions and alternative approaches that may prevent medicalization and the sustenance of the practice of FGM/C, including re-infibulation. The study finds …

Reducing Barriers To Accessing Fistula Repair: Implementation Research In Ebonyi, Pooja Sripad, Emmanuel Nwala, Vandana Tripathi

Reproductive Health

Female genital fistula is preventable and surgically treatable, but women who lack access to quality health care often live with fistula for many years. For every 1,000 births, an estimated 2.11 women develop fistula in Nigeria and despite the establishment of internationally accredited national fistula centers across the country, the majority of women live with unrepaired fistula. The Population Council, in collaboration with EngenderHealth and the Fistula Care Plus project, conducted implementation research to understand whether a comprehensive information, screening, and referral intervention reduces transportation, communication, and financial barriers to accessing preventive care, detection, and treatment of fistula in Ebonyi …

Reducing Barriers To Accessing Fistula Repair: Implementation Research In Katsina, Pooja Sripad, Emmanuel Nwala, Vandana Tripathi

Reproductive Health

Female genital fistula is preventable and surgically treatable, but women who lack access to quality health care often live with fistula for many years. For every 1,000 births, an estimated 2.11 women develop fistula in Nigeria and despite the establishment of internationally accredited national fistula centers across the country, the majority of women live with unrepaired fistula. The Population Council, in collaboration with EngenderHealth and the Fistula Care Plus project, conducted implementation research to understand whether a comprehensive information, screening, and referral intervention reduces transportation, communication, and financial barriers to accessing preventive care, detection, and treatment of fistula in Katsina …

Shifts In Female Genital Mutilation/Cutting In Kenya: Perspectives Of Families And Health Care Providers, Samuel Kimani, Caroline W. Kabiru

Reproductive Health

Despite compelling reasons and efforts to eradicate female genital mutilation/cutting (FGM/C) in Kenya, the practice has persisted, albeit with some changes. This study sought to understand the shifts in FGM/C among families and healthcare providers from selected Kenyan communities that practice FGM/C. Our findings highlight similarities and differences across three distinct Kenyan communities. FGM/C appears to persist through two models: first, shifts (changes) in the practice, notably cutting at a younger age, lesser cutting; and second, through stability and consistency with minimal change. The two diverse models appear to rely on and sustain social norms that support FGM/C in these …

Strengthening The Integration Of Family Planning And Hiv Services At The Community Level In Kenya, Wilson Liambila, Sara Chace Dwyer, Brian Mdawida, Charlotte E. Warren, Melsa Lutomia, Jane Koech, Elizabeth Washika, Aparna Jain

Reproductive Health

Study findings reveal that many Kenyan women living with HIV are comfortable receiving family planning (FP) services from community health volunteers and with proper training and support, community health volunteers have the potential to provide integrated FP/HIV services. Community-based integrated FP/HIV services could help connect women living with HIV who want to prevent or postpone a pregnancy to contraceptive services, which can reduce unintended pregnancies and in turn maternal mortality and vertical transmission of HIV. This implementation research study offers evidence of the feasibility, quality of care, and acceptability of using community health volunteers to integrate family planning into HIV/AIDS …

The Perspectives Of Men In Mexico City About Vasectomy, Isabel Vieitez Martínez, Adriana Ramos

Reproductive Health

As part of World Vasectomy Day, the Population Council Mexico conducted an exploratory study about the reasons and concerns that led men to seek a no-scalpel vasectomy (NSV) during the 24-hour “Vasectomy-athon” in Mexico City in 2017. This study was intended as the first part of a longer cohort study that would follow up with the men, and their partners, to learn about their experiences with the procedure and its effects, if any, on their relationships. Based on the findings, the report recommends that the Mexican Ministry of Health (SSA) continue integrating NSV information, counseling, and services within the National …

The Perspectives Of Men In Mexico City About Vasectomy—Brief, Isabel Vieitez Martínez, Adriana Ramos

Reproductive Health

On November 17, 2017, Mexico City took part in the global World Vasectomy Day campaign promoting men’s participation in family planning, especially through no-scalpel vasectomy (NSV). During the event the Population Council Mexico conducted an exploratory study to better understand the reasons men chose NSV, as well as their concerns before and after the procedure. The study found that the principal reason for seeking NSV among men surveyed was their achievement of a desired family size, for themselves and their partners. The study further reveals the need to disseminate information through mass media, social networks, and all levels of the …

The Rationale And Relevance Of Existing Cadres Of Frontline Health Workers And Potential For New Mid-Level Cadres, Oladimeji Oladepo, Ekechi Okereke, Akinwumi Akinola

Reproductive Health

Front-line health workers (FLHWs) are expected to perform necessary maternal, newborn, and child (MNCH) services appropriately and effectively; however, few studies have investigated the extent to which FLHWs perform requisite primary health care (PHC) services. This study seeks to better understand not only FLHWs’ knowledge and performance of MNCH services, but the factors promoting and inhibiting their services in selected rural local government areas of Nigeria’s Bauchi and Cross River states. It also investigates the potential for a new PHC worker cadre, soliciting stakeholders’ perceptions about its feasibility for addressing maternal and newborn disease burdens in rural communities. The study’s …

Tracing Change In Female Genital Mutilation/Cutting: Shifting Norms And Practices Among Communities In Narok And Kisii Counties, Kenya, Dennis Matanda, Chantalle Okondo, Caroline W. Kabiru, Bettina Shell-Duncan

Reproductive Health

In Kenya, there has been a steady and marked decline in the prevalence of female genital mutilation/cutting (FGM/C) but there is great variance in the prevalence of FGM/C across the country, with prevalence remaining high among certain ethnic groups such as Somali, Samburu, Kisii, and the Maasai. The objectives of this study were: 1) to explore whether and how unprogrammed factors or programmed FGM/C interventions (alternative rites of passage, legal and policy measures, religious-oriented approaches, promotion of girls’ education, intergenerational dialogues, use of rescue centers, and other undocumented approaches) influence community values deliberation in Narok and Kisii counties; 2) to …

Trends In Medicalisation Of Female Genital Mutilation/Cutting: What Do The Data Reveal?, Bettina Shell-Duncan, Carolyne Njue, Zhuzhi Moore

Reproductive Health

Despite the emergence of international consensus that female genital mutilation/cutting (FGM/C) is a violation of human rights, a focus on medicalization remains salient because of concerns that FGM/C is increasingly being performed by healthcare professionals and may be impeding progress toward abandonment of FGM/C. To investigate these claims, this study draws on nationally representative survey data from 26 countries, and addresses the following three questions: 1) What are the major patterns and trends in medicalisation? 2) Is there an association between medicalization and rates of change in prevalence of FGM/C? and 3) Is there an association between medicalization and support …

Understanding Medicalisation Of Female Genital Mutilation/Cutting (Fgm/C): A Qualitative Study Of Parents And Health Workers In Nigeria, Otibho Obianwu, Adetayo Adetunji, Osasuyi Dirisu

Reproductive Health

This community-based, cross-sectional qualitative study was conducted in four communities in Nigeria’s Delta, and was conceptualized to address gaps in our understanding of medicalization of female genital mutilation/cutting (FGM/C) and to provide critical evidence needed to effectively design abandonment interventions. The study findings reveal that the social norms driving FGM/C practice remain entrenched despite a shift to medicalization. They also reflect the tendency of parents and health workers to view FGM/C, whether traditional or medicalized, as a minor procedure with few complications and significant benefits that would positively impact a daughter’s future status as a wife and mother. Findings reveal …

Understanding The Key Elements For Designing And Implementing Social Marketing Campaigns To Inform The Development Of Creative Approaches For Fgm/C Abandonment In Sudan, Widad Ali A/Rahman, Samia Al Nagar, Randa H. Gindeel, Arwa Salah

Reproductive Health

Social marketing campaigns (SMCs) have gained prominence in female genital mutilation/cutting (FGM/C) abandonment efforts, but there is a dearth of information on how these programs are designed and implemented, and their perceived impact. Understanding the implementation process and the effectiveness of these campaigns is critical for drawing lessons to improve existing programs and inform the design and scale up of SMCs in other regions/countries. This mixed-method study sought to address this gap by assessing the design and implementation of existing SMC programs in Sudan. While the study findings demonstrate several strengths of existing programs, including strong partnerships and extensive needs …

Retrospective Cohort Study: Clinical Presentation And Outcomes Of Pre-Eclampsia And Eclampsia At Kenyatta National Hospital, Nairobi, Kenya, Charity Ndwiga, Alfred Osoti, Pooja Sripad, George Odwe, Omondi Ogutu, Charlotte E. Warren

Reproductive Health

Pre-eclampsia has two distinct subtypes: early onset pre-eclampsia, which occurs before 34 weeks of gestation, and late onset pre-eclampsia, which occurs after 34 weeks. Few studies examine and compare early and late onset pre-eclampsia in a low- and middle-income country setting. This study’s goal was to establish a profile of patients with hypertensive disorders in pregnancy, especially pre-eclampsia and eclampsia, over a two-year period. At Kenya’s national referral hospital, clinical presentation at admission was examined, as was management of complications, along with maternal and newborn health outcomes in the hospital’s maternity unit, to ascertain any differences in health outcomes for …

An Examination Of Socioeconomic Equity In Health Experiences In Six Latin American And Caribbean Countries, Jessica Greene, Frederico Guanais

Publications and Research

Objective: Most Latin American and Caribbean (LAC) countries are working toward the provision of universal health coverage, and ensuring equity is a priority for those nations. The goal of this study was to examine the extent to which adults’ socioeconomic status was related to health care experience in six LAC countries.

Methods: This cross-sectional study examined the relationship between educational attainment and seven health experience outcomes in three areas: assessment of the health system, access to care, and experience with general practitioner. For this work, we used data from an Inter-American Development Bank survey of adults in Brazil, Colombia, El …

Global Health Elective, Santiago, Dominican Republic, March 2018, July K. Jean Cuevas

Posters

Describes a global health learning experience to improve the knowledge of health care professionals and families about common developmental conditions, autism and ADHD.

Sawubona From Swaziland! - A Global Health View Of The Hiv/Aids Epidemic In Swaziland, Abby Hardin

Posters

Describes the learning experiences of a pediatric resident regarding how to practice evidence based medicine in low resource settings.