Maternal and Child Health Commons^™

Black Women Have The Highest Maternal Mortality Rate In The United States, Tori-Ann Haywood

Population Health Research Brief Series

The U.S. maternal mortality rate is consistently higher than its high-income peer countries. Since 2018 maternal mortality rates in the U.S. have steadily increased for all ethnoracial groups. This data slice uses data from the U.S. National Center for Health Statistics to describe U.S. maternity mortality rates for women ages 15-45 across different ethnoracial groups between 2018-2022. Results show that, except for non-Hispanic (NH) Asian women, ethnoracial minority women have higher maternal death rates than NH White women.

The Contradictory Nature Of U.S. Laws And Nutrition Programs And Their Effects On Infant Feeding, Lily Patel

Journal of Food Law & Policy

The contradictory nature of U.S. laws, including the laws concerning infant feeding, though supposedly aligned with policies to promote wellness in Americans, can exacerbate gender and race inequality and work against the National Strategy. The overarching goal of U.S. laws concerning infant feeding is to ensure that infants are fed, nourished, and receive proper nutrition. However, the laws often appear to be directly contradictory to one another in the priorities they are promoting.

Exploring The Willingness Toward Hiv Immediate Test And Treat Among Msm In Nairobi And Its Environs: A Cross-Sectional Study., Kingori Ndungu, Peter Gichanga, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: In the test and treat initiative, high-risk populations are screened for human immunodeficiency virus (HIV) infection and start early treatment if diagnosed positive. This study explores factors associated with willingness to initiate testing and immediate treatment among men who have sex with men (MSM) in Nairobi and its environs. The study was informed by a conceptual framework combining the AIDS Risk Reduction Model (ARRM) and the Modified Social Ecological Model.

Methods: This cross-sectional exploratory study targeted MSM (aged 18–60 years) reporting active engagement in anal or oral sex with men in Nairobi and its surrounding areas. Purposive sampling was …

Pattern And Determinants Of Contraceptive Use Among The Muslim Women In Wajir And Lamu Counties In Kenya: A Cross-Sectional Study., Batula Abdi, Jerry Okal, Gamal Serour, Vincent Were, Marleen Temmerman, Peter Gichangi

Centre of Excellence in Women and Child Health

Background; Improving access to family planning (FP) is associated with positive health benefits that includes averting nearly a third of all maternal deaths and 10% of childhood deaths. Kenya has made great strides in improving access to family planning services. However, amid this considerable progress, regional variation has been noted which begs the need for a clearer understanding of the the patterns and determinants that drive these inconsistencies.

Methods; We conducted a cross-sectional study that involved 663 Muslim women of reproductive age (15–49 years) from Wajir and Lamu counties in Kenya between March and October 2018.The objective of this study …

Inequalities In Use Of Hospitals For Childbirth Among Rural Women In Sub-Saharan Africa: A Comparative Analysis Of 18 Countries Using Demographic And Health Survey Data., Manuela Straneo, Claudia Hanson, Thomas Van Den Akker, Bosede Afolabi, Anteneh Asefa, Alexandre Delamou, Mardieh Dennis, Luis Gadama, Nyika Mahachi, Welcome Mlilo

Centre of Excellence in Women and Child Health

Introduction; Rising facility births in sub-Saharan Africa (SSA) mask inequalities in higher-level emergency care— typically in hospitals. Limited research has addressed hospital use in women at risk of or with complications, such as high parity, linked to poverty and rurality, for whom hospital care is essential. We aimed to address this gap, by comparatively assessing hospital use in rural SSA by wealth and parity.

Methods; Countries in SSA with a Demographic and Health Survey since 2015 were included. We assessed rural hospital childbirth stratifying by wealth (wealthier/poorer) and parity (nulliparity/high parity≥5), and their combination. We computed percentages, 95% CIs and …

The Alignmnh 2023 Conference: Progress In Raising Parents’ Voices In Stillbirth Advocacy., Grace Mwashigadi, Treasure Lwantale, Aleena Wojcieszek, Hannah Blencowe, Susannah Hopkins Leisher, Caroline Wanjiru Kiunga, David Wanjala, Claire Storey

Centre of Excellence in Women and Child Health

No abstract provided.

Determinants Of Immunization In Polio Super High-Risk Union Councils Of Pakistan, Ahmad Khan, Imtiaz Hussain, Dale A. Rhoda, Muhammad Umer, Uzair Ansari, Imran Ahmed, Caitlin Clary, Rana Muhammad Safdar, Sajid Bashir Soofi

Centre of Excellence in Women and Child Health

Background: The current polio epidemiology in Pakistan poses a unique challenge for global eradication as the country is affected by ongoing endemic poliovirus transmission. Across the country, 40 union councils (UCs) which serve as core reservoirs for poliovirus with continuous incidences of polio cases are categorized as super-high-risk union councils (SHRUCs).
Methodology: A cross-sectional survey was conducted in 39 SHRUCs using a two-stage stratified cluster sampling technique. 6,976 children aged 12-23 months were covered. A structured questionnaire was used for data collection. Data were analyzed using STATA version 17.
Results: Based on both vaccination records and recall, 48.3% of children …

Rapidiron Trial Follow-Up Study - The Rapidiron-Kids Study: Protocol Of A Prospective Observational Follow-Up Study, Richard Derman, Roopa Bellad, Mrutyunjaya Bellad, Jesse Bradford-Rogers, Michael Georgieff, Zubair Aghai, Simal Thind, Michael Auerbach, Rupsa Boelig, Benjamin Leiby, Vanessa Short, S. Yogeshkumar, Umesh Charantimath, Manjunath Somannavar, Ashalata Mallapur, Ramesh Pol, Umesh Ramadurg, Radha Sangavi, Basavaraj Peerapur, Nasima Banu, Praveen Patil, Amaresh Patil, Subarna Roy, Phaniraj Vastrad, Dennis Wallace, Hemang Shah, Shivaprasad Goudar

Global Health Articles

BACKGROUND: Anemia is a worldwide problem with iron deficiency being the most common cause. When anemia occurs in pregnancy, it increases the risk of adverse maternal, fetal, and postnatal outcomes. It induces preterm births and low birth weight (LBW) deliveries, long-term neurodevelopmental sequelae, and an increased risk of earlier onset of postnatal iron deficiency. Anemia rates are among the highest in South Asia, and India's National Family Health Survey (NFHS-5) for 2019-2021 indicated that over half of pregnant women, and more than 65% of children, in the country are classified as anemic (Sciences IIfP, National Family Health Survey-5, 2019-21, India …

Comparing The Effectiveness Of Mother-Focused Interventions To That Of Mother-Child Focused Interventions In Improving Maternal Postpartum Depression Outcomes: A Systematic Review, Divya Kumar, Waqas Hameed, Bilal Iqbal Avan

Community Health Sciences

Background: Most empirically researched interventions for postpartum depression (PPD) tend to target mothers' depression alone. Harmful effects of PPD on physical and mental health of both mother and child has led researchers to investigate the impact of interventions on PPD and child outcomes together. So far, the evidence is limited regarding how these interventions compare with those focusing only on mothers' depression. This review compares the effectiveness of PPD-improving interventions focusing only on mothers with those focusing on mother and child together.
Methods: Nine electronic databases were searched. Thirty-seven studies evaluating mother-focused (n = 30) and mother-child focused interventions (n …

Unravelling The Potential Mortality Benefits Of Mass Drug Administration With Azithromycin In Niger, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

No abstract provided.

Postmortem Minimally Invasive Tissue Sampling In Communities: Exploring Perceptions Of Families, Funeral Workers, Religious And Community Leaders And Healthcare Providers From Pakistan, Nazia Ahsan, Fauzia Aman Malik, Waliyah Mughis, Rawshan Jabeen, Shaheen Mehboob, Raheel Allana, Syeda Quratulain, Saima Jamal Saima Jamal, Christina R. Paganelli, Abdul Momin Kazi

Department of Paediatrics and Child Health

Background: Minimally invasive tissue sampling (MITS) has increasingly been used to improve the diagnosis of disease and identification of the cause of death, particularly in underserved areas. However, there are multiple barriers to accessing those who die within the community, our study aimed to explore the perceptions and insights of community members and healthcare providers regarding the feasibility of implementing MITS in community settings.
Methods: A qualitative exploratory study was conducted. A total of twenty one in-depth interviews were conducted with deceased infants' parents, elders of the family, religious leaders, community leaders, and funeral workers. Focus group discussions were conducted …

Bridging The Gap: Reducing Disparities In Reproductive Healthcare For Black And White Women, Emma Weiden

Population Health Research Brief Series

A woman’s reproductive healthcare experience in the United States can vary dramatically depending on her race. In 2020, the pregnancy-related mortality rate in the U.S. was 40.8 deaths per 100,000 live births for Black women, which is more than three times the rate among White women (12.7 per 100,000). This brief summarizes disparities in reproductive healthcare outcomes for Black women compared to White women in the U.S., advocates for policy changes, and provides recommendations for addressing racial disparities to create more equitable reproductive healthcare.

Sars-Cov-2 Seroprevalence In Pregnant Women In Kilifi, Kenya From March 2020 To March 2022, Angela Koech, Geoffrey Omuse, Alex Mugo, Isaac Mwaniki, Joseph Mutunga, Moses Mukhanya, Onesmus Wanje, Grace Mwashigadi, Geoffrey Katana, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: Seroprevalence studies are an alternative approach to estimating the extent of transmission of SARS-CoV-2 and the evolution of the pandemic in different geographical settings. We aimed to determine the SARS-CoV-2 seroprevalence from March 2020 to March 2022 in a rural and urban setting in Kilifi County, Kenya.

Methods: We obtained representative random samples of stored serum from a pregnancy cohort study for the period March 2020 to March 2022 and tested for antibodies against the spike protein using a qualitative SARS-CoV-2 ELISA kit (Wantai, total antibodies). All positive samples were retested for anti-SARS-CoV-2 anti-nucleocapsid antibodies (Euroimmun, ELISA kits, NCP, …

Certified Midwives: An Exploration Of Their Impact On Maternal Health Outcomes – A Comprehensive Literature Review, Heather Hollister

Capstone Experience

Maternal health outcomes in the United States have been consistently worse than other high-income countries, with a disproportionate impact on women of color. Midwives have long played an important role in maternal health worldwide. The literature review examines the evidence for midwives as key contributors to improving maternal health outcomes. The paper reviews the existing literature on midwifery, including the impact on maternal health, labor and delivery outcomes, and patient satisfaction. Electronic searches were conducted through Cochrane Library, CINAHL, Medline and Embase. Articles were screened according to inclusion and exclusion criteria including that they must be a randomized study; participants …

Strategies To Encourage Recall And Prevent Relapse After Full Mouth Rehabilitation Under General Anesthesia In Children, Claire Koukol

Capstone Experience

Background: Dental caries are preventable. Dentists utilize many prevention strategies in the office and provide at-home education to families. However, once a child develops Early Childhood Caries (ECC), especially in more severe cases, they may need general anesthesia (GA) to complete treatment. While this is an effective way to achieve full mouth dental rehabilitation (FMDR), this burdens the healthcare systems and families and does not come without risk to the patient. Patients with high caries experience remain at high risk of caries relapse after FMDR under GA, sometimes necessitating additional FMDR under GA. While there has been a significant amount …

Exploring The Mental Health Experience Of Perinatal Military Spouses Based In Sigonella, Italy, Lyndsey Dannenberg

Capstone Experience

The perinatal period can have a profound impact on the mental health of women, their infants, and their families, especially when it comes to depression and anxiety disorders. This study aims to delve into the experiences of perinatal mental health among military spouses stationed overseas, on Naval Air Station Sigonella, Italy, and contribute to the limited research on active-duty military spouses and their perinatal mental health while stationed overseas. The research uses a qualitative phenomenological approach, seeking to provide valuable insights into the lived experiences of military spouses and their perinatal mental health. Risk factors associated with perinatal mental illness …

Planners Vs. Non-Planners: Do Preterm Births Impact Future Contraceptive Use?, Jessie Moore

NYMC Student Theses and Dissertations

Background: In the United States, 45% of all pregnancies are unintended and occur when contraception is not used or is used inconsistently. Among those pregnancies, 1 in 10 women will experience a preterm birth, which is defined as a birth occurring before 37 weeks gestation. Women who have delivered preterm are at an increased risk for preterm birth in future pregnancies and are encouraged to wait at least 18 months between giving birth and getting pregnant again. Among women who have experienced a preterm birth, the desire to delay future pregnancy or avoiding it all together often becomes a necessity …

Bridging Gaps: A Qualitative Inquiry On Improving Paediatric Rheumatology Care Among Healthcare Workers In Kenya, Angela Migowa, Sasha Bernatsky, Anthony Ngugi, Helen Foster, Peterrock Muriuki, Roselyter Riang’A, Stanley Luchters

Paediatrics and Child Health, East Africa

Background: Due to the paucity of paediatric rheumatologists in Kenya, it is paramount that we explore strategies to bridge clinical care gaps for paediatric rheumatology patients in order to promote early diagnosis, prompt referral, and optimal management.

Purpose: To identify proposed interventions which can improve the ability of non-specialist healthcare workers to care for paediatric rheumatology patients across Kenya.

Methods: We conducted 12 focus group discussions with clinical officers (community physician assistants), nurses, general practitioners and paediatricians across six regions in Kenya. Interviews were conducted, audio-recorded, transcribed verbatim, and analysed using MAXQDA 2022.2 software.

Results: A total of 68 individuals …

Stigma And Mothers Using Opioids, Amelia Van Komen, Maren Wright Voss, Amy Campbell

All Current Publications

Parenting and pregnancy in the context of substance use is a complicated topic. Many public health officials, social workers, policy makers, and community members want to provide effective support and treatment for the child and for the parent. But when stigma, prejudice, or misinformation occur, parents who use substances can be exposed to added barriers to accessing care and support. This fact sheet addresses solutions to these barriers.

Maternal Age Extremes And Adverse Pregnancy Outcomes In Low-Resourced Settings, Paul Nyongesa, Osayame Ekhaguere, Irene Marete, Constance Tenge, Milsort Kemoi, Carla Bann, Sherri Bucher, Archana Patel, Patricia Hibberd, Farnaz Naqvi, Sarah Saleem, Robert Goldenberg, Shivaprasad Goudar, Richard Derman, Nancy Krebs, Ana Garces, Elwyn Chomba, Waldemar Carlo, Musaku Mwenechanya, Adrien Lokangaka, Antoinette Tshefu, Melissa Bauserman, Marion Koso-Thomas, Janet Moore, Elizabeth Mcclure, Edward Liechty, Fabian Esamai

Global Health Articles

INTRODUCTION: Adolescent (years) and advanced maternal age (>35 years) pregnancies carry adverse risks and warrant a critical review in low- and middle-income countries where the burden of adverse pregnancy outcomes is highest.

OBJECTIVE: To describe the prevalence and adverse pregnancy (maternal, perinatal, and neonatal) outcomes associated with extremes of maternal age across six countries.

PATIENTS AND METHODS: We performed a historical cohort analysis on prospectively collected data from a population-based cohort study conducted in the Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia between 2010 and 2020. We included pregnant women and their neonates. We describe the …