Maternal and Child Health Commons^™

Operationalizing And Scaling Up Hiv/Rh Referrals In Kenya: The Way Forward, Aphia Ii Or Project In Kenya

Reproductive Health

This policy brief describes the APHIA II Operations Research Project through which the Population Council and Kenya’s Ministry of Health (MOH) developed and tested an approach to systematically link HIV-positive family planning (FP) clients to treatment and care services. Key activities included provider training and testing of a referral package which showed how, where, when, and who is to make and receive referrals. This referral package consisted of a directory listing all facilities in the vicinity available for services including HIV counseling and testing, FP, STIs, tuberculosis, and well-child checks; and referral forms directing clients to appropriate receiving clinics. The …

Service Improvements And Community Education Lead To Increase In Uptake Of Hiv Services For Infants And Young Children, Population Council

Reproductive Health

The Population Council’s APHIA II Operations Research Project in Kenya collaborated with Kendu Adventist Hospital and the Christian Health Association to launch a study to examine the effect of improved services and awareness-creation on the uptake of HIV testing and treatment services for children and infants exposed to HIV. The study showed that community education and improvements in individual case tracking can increase the proportion of infants exposed to HIV who are tested for HIV and put on appropriate treatment. The policy brief recommends that health facilities streamline services to ensure that as many exposed infants as possible are identified …

Increasing Access To Family Planning (Fp) And Reproductive Health (Rh) Services Through Task-Sharing Between Community Health Workers (Chws) And Community Mid-Level Professionals In Large-Scale Public-Sector Programs: A Literature Review To Help Guide Case Studies, James R. Foreit, Sarah Raifman

Reproductive Health

This literature review covers case studies related to community-based distribution of family planning programs, and community health worker (CHW) programs that included family planning and other reproductive health services. It offers essential processes and implications for additional operations research which look at constraints and factors critical to introducing new program procedures or strengthening existing ones.

Informe Años Dos Movil.Com: Evaluación De La Línea Final Resumen De Hallazgos Principales, Annik Sorhaindo, Xipatl Contreras, Kate S. Wilson, Sandra G. Garcia

Reproductive Health

This report highlights the findings of the endline evaluation of a two-year leadership project aimed at indigenous youth in Oaxaca, Mexico: Movil.com. Movil.com is a community project headed by peers and built on elements of other models. It is similar to a cascaded peer education and training model, in which nuclear leaders are trained who, in turn, train facilitators of larger groups. The Population Council office in Mexico evaluated the project at the request of the social organization that implements it, the Rosales Castellanos Women's Study Group, an NGO that has worked for more than 30 years with indigenous communities …

In Search Of Wellness: Allied Health Professionals' Understandings Of Wellness In Childhood Disability Services, Lauren Breen, Helen Wildy, Sherry Saggers, Jeannine Millsteed, P Raghavendra

Research outputs 2011

Purpose. Wellness approaches are not routine in childhood disability services, despite theoretical and empirical support and an increasing demand for them from health consumers and disability activists. We aimed to investigate how health professionals define or understand wellness and its practice in the context of childhood disability. Method. A qualitative, interpretive approach was taken. Semi-structured interviews were conducted with 23 health professionals (allied health therapists and managers) providing early intervention and ongoing therapy within four Australian childhood health and disability services. Years of experience providing services to children with disabilities and their families ranged from 6 months to 30 years …

Aplastic Anemia: Clinicohaematological Features, Treatment And Outcome Analysis, Rabia Wali, Zehra Fidoo, Salman Adil, Muhammad Ahmed Naqvi

Department of Pathology and Laboratory Medicine

Objective: To determine the clinicohaematological features, treatment and outcome of children diagnosed with aplastic anemia at a single institution.

Study Design: Observational study.

Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 1999 till December 2008.

Methodology: Medical records of children aged less than 15 years of age diagnosed with aplastic anemia were reviewed. Clinicohaematological features, treatment and its response to therapy and outcome were recorded. Results were described in percentages.

Results: Ninety patients were diagnosed to have aplastic anemia (AA); 65 were male during the study period. Age ranged from 1 to 15 years. Fever …

Maternal Exposure To The Holocaust And Health Complaints In Offspring, Janine D. Flory, Linda M. Bierer, Rachel Yehuda

Publications and Research

Although the link between chronic stress and the development of cardiovascular and metabolic diseases of adulthood has been known for some time, there is growing recognition that early environmental influences may result in developmental programming via epigenetic mechanisms, thereby affecting the developmental trajectory of disease progression. Previous studies support the idea that offspring of Holocaust survivors may have been subjected to early developmental programming. We evaluated the relationship between parental exposure to the Holocaust and selfreported health ratings and disorders made by their adult offspring (i.e., second generation Holocaust survivors). A total of 137 subjects were evaluated. Regression analyses demonstrated …

Prenatal Programming Of Human Neurological Function, Curt A. Sandman, Elyssia Poggi Davis, Claudia Buss, Laura M. Glynn

Psychology Faculty Articles and Research

The human placenta expresses the genes for proopiomelanocortin and the major stress hormone, corticotropin-releasing hormone (CRH), profoundly altering the "fight or flight" stress system in mother and fetus. As pregnancy progresses, the levels of these stress hormones, including maternal cortisol, increase dramatically. These endocrine changes are important for fetal maturation, but if the levels are altered (e.g., in response to stress), they influence (program) the fetal nervous system with long-term consequences. The evidence indicates that fetal exposure to elevated levels of stress hormones (i) delays fetal nervous system maturation, (ii) restricts the neuromuscular development and alters the stress response of …

Teen Pregnancy Prevention Program Year One Outcome Evaluation Report For The Southern Nevada Health District, Nevada Institute For Children’S Research And Policy, Southern Nevada Health District, Tara Phebus, Samantha Dawn Beecher, Alyson Baker, Taylor Oliver, Denise Tanata Ashby

Nevada Institute for Children's Research and Policy Reports

In the fall of 2010 the Southern Nevada Health District (SNHD) was awarded funding from the Federal Office of Adolescent Health to implement an evidence based teen pregnancy prevention curriculum. They have partnered with the Department of Juvenile Justice Services and the Clark County Department of Family Services to offer this curriculum to the youth in juvenile detention, probation, and life skills classes for youth aging out of the foster care system. The Nevada Institute for Children’s Research and Policy (NICRP) has been contracted to complete the outcome evaluation for this program and is collecting data to help measure the …

Prenatal Maternal Stress Programs Infant Stress Regulation, Elyssia Poggi Davis, Laura M. Glynn, Feizal Waffarn, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: Prenatal exposure to inappropriate levels of glucocorticoids (GCs) and maternal stress are putative mechanisms for the fetal programming of later health outcomes. The current investigation examined the influence of prenatal maternal cortisol and maternal psychosocial stress on infant physiological and behavioral responses to stress.

Methods: The study sample comprised 116 women and their full term infants. Maternal plasma cortisol and report of stress, anxiety and depression were assessed at 15, 19, 25, 31 and 36 + weeks' gestational age. Infant cortisol and behavioral responses to the painful stress of a heel-stick blood draw were evaluated at 24 hours after …

Development Of Fetal Movement Between 26 And 36 Weeks’ Gestation In Response To Vibroacoustic Stimulation, Marybeth Grant-Beuttler, Laura M. Glynn, Amy L. Salisbury, Elyssia Poggi Davis, Carol Holliday, Curt A. Sandman

Psychology Faculty Articles and Research

BACKGROUND: Ultrasound observation of fetal movement has documented general trends in motor development and fetal age when motor response to stimulation is observed. Evaluation of fetal movement quality, in addition to specific motor activity, may improve documentation of motor development and highlight specific motor responses to stimulation.

AIM: The aim of this investigation was to assess fetal movement at 26 and 36-weeks gestation during three conditions (baseline, immediate response to vibro-acoustic stimulation (VAS), and post-response).

DESIGN: A prospective, longitudinal design was utilized.

SUBJECTS: Twelve normally developing fetuses, eight females and four males, were examined with continuous ultrasound imaging.

OUTCOME MEASURES: …

Maternal Defense: Breastfeeding Heightens Aggression By Reducing Stress, Jennifer Hahn-Holbrook, Julianne Holt-Lunstad, Colin Holbrook, Sarah M. Coyne, E. Thomas Lawson

Psychology Faculty Articles and Research

Mothers in numerous species exhibit heightened aggression in defense of their young. This shift typically coincides with the duration of lactation in nonhuman mammals, which suggests that human mothers may display similarly accentuated aggressiveness while breast feeding. Here we report the first behavioral evidence for heightened aggression in lactating humans. Breast-feeding mothers inflicted louder and longer punitive sound bursts on unduly aggressive confederates than did formula-feeding mothers or women who had never been pregnant. Maternal aggression in other mammals is thought to be facilitated by the buffering effect of lactation on stress responses. Consistent with the animal literature, our results …

The Effect Of Female Education On Fertility And Infant Health: Evidence From School Entry Policies Using Exact Date Of Birth, Justin Mccrary, Heather Royer

Faculty Scholarship

This paper uses age-at-school-entry policies to identify the effect of female education on fertility and infant health. We focus on sharp contrasts in schooling, fertility, and infant health between women born just before and after the school entry date. School entry policies affect female education and the quality of a woman’s mate and have generally small, but possibly heterogeneous, effects on fertility and infant health. We argue that school entry policies manipulate primarily the education of young women at risk of dropping out of school.

Factors Associated With Tobacco Use Among Rural And Urban Pregnant Women, Whitney Jeanne Katirai

University of Kentucky Doctoral Dissertations

The purpose of this study was to investigate the influences of smoking on rural and urban pregnant women. More specifically, the variables of the knowledge of health effects, health provider recommendations, subscores from the Health Belief Model (HBM), and social support were explored in relation to the smoking behavior of pregnant women. A secondary purpose was to investigate the accuracy of self-reported smoking during pregnancy using biochemical validation. Pregnant women (N=71) completed an anonymous questionnaire, designed by the researcher, to identify variables that predicted smoking for urban and rural women. Participants also gave a saliva sample for cotinine testing.

Approximately …

Perceptions Of Maternal Stress And Neonatal Patient Outcomes In A Single Private Room Versus Open Room Neonatal Intensive Care Unit Environment., Lisa M. Smithgall

Electronic Theses and Dissertations

Limited clinical evidence exists regarding whether the single private room Neonatal Intensive Care Unit (NICU) environment of care delivery has a positive, negative, or neutral impact on health outcomes for the high risk neonate and on maternal stress as compared to the open room design. The study purpose was to examine whether a difference exists in health outcomes in the open room versus single private room NICU environment. The factors considered were weight gain, ventilator days, hospital length of stay, incidence and grade of intraventricular hemorrhage (IVH), the number of parental visits, and perceptions of maternal stress. Infants hospitalized in …

Communities, Birth Attendants And Health Facilities: A Continuum Of Emergency Maternal And Newborn Care (The Global Network's Emonc Trial), Omrana Pasha, Robert L. Goldenberg, Elizabeth M. Mcclure, Sarah Saleem, Shivaprasad S. Goudar, Fernando Althabe, Archana Patel, Fabian Esamai, Ana Garces, Elwyn Chomba, Manolo Mazariegos, Bhala Kodkany, Jose M. Belizan, Richard J. Derman, Patricia L. Hibberd, Waldemar A. Carlo, Edward A. Liechty, K. Michael Hambidge, Pierre Buekens, Dennis Wallace, Lisa Howard-Grabman, Suzanne Stalls, Marion Koso-Thomas, Alan H. Jobe, Linda L. Wright

Community Health Sciences

Background: Maternal and newborn mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and newborn care services has been proposed by several organizations in order to improve pregnancy outcomes. However, the effectiveness of emergency obstetric and neonatal care services has never been proven. Also unproven is the effectiveness of community mobilization and community birth attendant training to improve pregnancy outcomes. Methods/Design: We have developed a cluster-randomized controlled trial to evaluate the impact of a comprehensive intervention of community mobilization, birth attendant training and …

Community-Based Intervention Packages For Reducing Maternal And Neonatal Morbidity And Mortality And Improving Neonatal Outcomes, Zohra S. Lassi, Batool A. Haider, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: While maternal, infant and under-five child mortality rates in developing countries have declined significantly in the past two to three decades, newborn mortality rates have reduced much more slowly. While it is recognised that almost half of the newborn deaths can be prevented by scaling up evidence-based available interventions such as tetanus toxoid immunisation to mothers, clean and skilled care at delivery, newborn resuscitation, exclusive breastfeeding, clean umbilical cord care, management of infections in newborns, many require facility based and outreach services. It has also been stated that a significant proportion of these mortalities and morbidities could also be …

A Qualitative Study Of Coping In Mothers Of Children With An Autism Spectrum Disorder, Heather Miller Kuhaneck, Tajhma Burroughs, Jamie Wright, Theresa Lemanczyk, Amy Rowntree Darragh

Occupational Therapy Faculty Publications

A significant body of research exists that explores the stressors of raising a child with an autism spectrum disorder (ASD). There are fewer studies, however, that examine specific effective coping strategies of mothers of children with an ASD. This qualitative study explored mothers’ perceptions of effective coping strategies for their parenting stressors. In-depth interviews were conducted with 11 mothers to inquire about their personal coping methods. Interviews were coded and emergent themes identified which included coping strategies such as “me time,” “planning,” “knowledge is power,” “sharing the load,” “lifting the restraints of labels,” and “recognizing the joys.” The information from …

El Papel De La Educación Y Las Ong’S En Mejorar El Acceso A Derechos Para Inmigrantes: El Caso De Los Derechos Sexuales Y Reproductivos = The Role Of Education And Ngo’S In Helping Immigrants Obtain Better Access To Their Rights: The Specific Case Of Sexual And Reproductive Rights, Amy Torres

Independent Study Project (ISP) Collection

In January of 2004, Argentina approved a new immigration law that guaranteed the protection of human rights for all immigrants in the country regardless of their legal status with the State. Among the rights explicitly guaranteed by this law were the right to migrate, the right to education and the right to health care. While this law represents a significant advance by the Argentine government in protecting the human rights of immigrants, oppressive mechanisms still remain in everyday practices that inhibit actual access to their rights.

Considering the changes in the law and the breach between the laws and everyday …

Education As A Detour On The Path To Inevitable Motherhood: The Acquired Values And Collective Ambitions Of The Students At La Maison D’Education Mariama Ba, Hannah Deangelis

Independent Study Project (ISP) Collection

The values young Senegalese women acquire at home revolve around motherhood, domesticity and, above all, solidarity. The students lucky enough to attend La Maison D’Education Mariama Ba, the most elite girl’s high school in all of Senegal carry these community-centered values. Here, young Senegalese women have a chance to take a detour from the prescribed path that their gender has dictated by spending seven years living and studying with their peers in a highly intellectual setting. An understanding of the narratives of their lives before school, time spent at MEMB, and vision of their futures provides a lens through which …