Maternal and Child Health Commons^™

Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji

Theses & Dissertations

Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In …

Reducing The Postpartum Readmission Rate With Standardized Discharge Teaching, Darlene Day-Herzog

Master's Projects and Capstones

Problem: Hospital readmission rates are one of the quality metrics that matter for hospital reimbursements. In a large Northern California healthcare system, the postpartum readmission rate is often above the national average.

Context: The hospital designated as the main location for high-risk deliveries within a 30-mile radius has an Acute Care Obstetric postpartum population where twenty percent of the patients are at an increased risk for readmission.

Interventions: The project implemented the use of a standardized discharge teaching script and educational materials to be used by nursing staff throughout the patient’s hospital stay to see if multimodal standardization leads to …

Complementary Or Alternative Medicine Usage Of Mothers Seeking To Prevent Coronavirus Illness Or Manage Symptoms: Identifying Relationships Existing Between Mental Constructs And Concepts Of The Health Belief Model, Gabrielle Frachiseur

Health and Kinesiology Theses

Background: Mothers are the central supportive structure in most households. Mothers can become overwhelmed by informational overload when selecting the most appropriate modalities of care to provide for their families during the pandemic. The researcher sought to discover the prevalence of complementary or alternative medicine usage (CAM) for the prevention of coronavirus illness or symptoms management. Additionally, the researcher sought to identify the relationship between three additional mental constructs; knowledge, attitudes and beliefs, and constructs of the Health Belief Model, that could affect CAM adoption.

Methods: A cross-sectional survey was dispersed to 5 private Facebook groups. The survey was targeted …

Association Between Teenage Pregnancy And Family Factors: An Analysis Of The Philippine National Demographic And Health Survey 2017, Kozue Tabei, Erlinda Susana S. Cuisia-Cruz, Chris Smith, Xerxes Seposo

Ateneo School of Medicine and Public Health Publications

Adolescence is a key developmental period in one’s life course; health-related behaviors of adolescents can be linked to lifelong consequences, which affect their future health. Previous studies highlight the role of family and its significant association with adolescents’ health. In East Asia and the Pacific, the Philippines is the only country that is showing an upward trend of teenage pregnancy while other countries in the region have declining teenage pregnancy rates. Against this backdrop, this study investigated the association between teenage pregnancy and family factors, specifically parent structure. Data for the study were extracted from the Philippine National Demographic and …

When A Woman Goes To Jail, Renee Onque, Emily Nadal

Capstones

The United States holds 30% of the world’s incarcerated women and the laws protecting their specific needs while in the prison system differ by state. New York, Minnesota and Alabama are introducing innovative ways to improve the birthing experiences of women who are incarcerated. From programs that allow mothers to send their breast milk on dry ice to their babies to nurseries within prisons that allow babies to live with their moms for up to a year, these states are pushing for progressive changes for mothers in the system. https://reneeonque.github.io/capstone/

Combined Clinical Audits And Low-Dose, High-Frequency, In-Service Training Of Health Care Providers And Community Health Workers To Improve Maternal And Newborn Health In Mali: Protocol For A Pragmatic Cluster Randomized Trial, David Zombre, Jean-Luc Kortenaar, Farhana Zareef, Moussa Doumbia, Sekou Doumbia, Fadima Haidara, Katie Mclaughlin, Samba Sow, Zulfiqar Ahmed Bhutta, Diego G. Bassani

Centre of Excellence in Women and Child Health

Background: Although most births in Mali occur in health facilities, a substantial number of newborns still die during delivery and within the first 7 days of life, mainly because of existing training deficiencies and the challenges of maintaining intrapartum and postpartum care skills.
Objective: This trial aims to assess the effectiveness and cost-effectiveness of an intervention combining clinical audits and low-dose, high-frequency (LDHF) in-service training of health care providers and community health workers to reduce perinatal mortality.
Methods: The study is a three-arm cluster randomized controlled trial in the Koulikoro region in Mali. The units of randomization are each of …

Validation Of A Brazilian Portuguese Measure Of Family Resources In A Sample Of Parents To Children With Congenital Zika Virus Syndrome, Sarah Barker Ladd

College of Education and Human Sciences: Dissertations, Theses, and Student Research

In the aftermath of the 2015 Zika virus outbreak in Brazil, thousands of children and their families continue to face challenges associated with Congenital Zika Syndrome, a developmental condition associated with microcephaly and other serious birth defects affecting the central nervous system. Family-centered rehabilitative care is critical to optimize the trajectories of children who have significant developmental disabilities like CZS. These services involve assessing for the presence of family resources that may help to promote positive outcomes for children. Little is known regarding family resources in the context of caring for a child with CZS in Brazil due to the …

Changing Perceptions Of Rural Frontline Workers And Caregivers About Management Of Childhood Diarrhea And Pneumonia Despite Several Inequities: The Nigraan Plus Trial In Pakistan, Fauziah Rabbani, Hyder Ali Khan, Suneel Piryani, Nousheen Pradhan, Natasha Shaukat, Anam Shahil Feroz, Shagufta Perveen

Community Health Sciences

Purpose: Diarrhea and pneumonia greatly contribute to high childhood mortality in Pakistan. Frontline community health workers or the Lady Health Workers (LHWs) provide care at the doorstep of over 60% of Pakistan's rural residents. Difficult terrain, lack of supplies, and inadequate supervision put these LHWs at an added disadvantage in the timely diagnosis and delivery of known treatment options to community caregivers (CCGs). This study aims to assess whether a supportive supervision intervention through Lady Health Supervisors (LHSs) using enhanced mentorship and written feedback cards have the potential to improve case management of childhood diarrhea and pneumonia.
Study setting and …

Radical Support: Understanding Doula Work As Resistance To Routinized Violence, Arianna Parkhideh

Senior Honors Papers / Undergraduate Theses

Continuous support during labor has been demonstrated to have positive effects on maternal and infant health, as well as improving birth experiences. The benefits of doula support are particularly important for improving the maternal and infant health outcomes for Black pregnant individuals and others facing health inequities. The role of doulas in addressing the Black maternal health crisis motivates this study of the underlying mechanisms through which doulas support clients and operate within hospital settings to create positive outcomes. An online survey was used to understand the perspectives of doulas on the Black maternal health crisis and the strategies they …

Disparities Among Black Women In Maternal Health, Josefina Teresa Estrada

Nursing | Senior Theses

The literature shows that Black women face many disparities in terms of health care access and the quality of care. These obstacles could negatively affect the health of the mother and their child. This paper includes a literature review and proposed research study. The objective of this research study is to identify the outcomes of Black women compared to White women and other women of color in terms of maternal health. A literature review is provided in order to identify how race affects the following factors: obstacles that limit access to healthcare, rates of obtaining prenatal care, postpartum outcomes and …

The Yearly Financing Need Of Providing Paid Maternity Leave In The Informal Sector In Indonesia, Adiatma Y. M. Siregar, Pipit Pitriyan, Donny Hardiawan, Paul Zambrano, Mireya Vilar-Compte, Graciela Ma Teruel Belismelis, Meztli Moncada, David Tamayo, Grace Carroll, Rafael Perez-Escamilla, Roger Mathisen

Department of Public Health Scholarship and Creative Works

Background: The economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15–49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) and assisted by unpaid/family worker(s). No specific maternity protection entitlements are currently available for WRA working informally in Indonesia. This study aims to estimate the financing need of providing maternity leave cash transfer (MCT) for WRA working in the informal sector in Indonesia. Method: The costing methodology …

Breastfeeding Media Coverage And Beliefs During The Covid-19 Pandemic In Mexico: Implications For Breastfeeding Equity, Mireya Vilar-Compte, P. Gaitán‐Rossi, E. C. Rhodes, V. Cruz‐Villalba, R. Pérez‐Escamilla

Department of Public Health Scholarship and Creative Works

Background: Because breastfeeding offers short- and long- term health benefits to mothers and children, breastfeeding promotion and support is a public health priority. Evidence shows that SARS-CoV-2 is not likely to be transmitted via breastmilk. Moreover, antibodies against SARS-CoV-2 are thought to be contained in breastmilk of mothers with history of COVID-19 infection or vaccination. WHO recommends direct breastfeeding as the preferred infant feeding option during the COVID-19 pandemic, even among women with COVID-19; but conflicting practices have been adopted, which could widen existing inequities in breastfeeding. This study aims to describe how information about breastfeeding was communicated in Mexican …

Maternal Mortality: A Growing Health Inequity In America, Michala Geraty

Senior Honors Theses

The United States (U.S.) is known for its quest for knowledge, innovation, and advancements in all disciplines. However, it has the highest maternal mortality ratio (MMR) among developed nations. The US MMR increased from 12.7 to 17.4 per 100,000 live births between 2007 and 2018. Over 60% of these deaths are preventable, indicating room for improvement. African American or non-Hispanic Black women are disproportionately affected, at over twice the rate of their non-Hispanic White and Hispanic counterparts. The proximal (e.g., individual level) determinants have not been able to fully explain these inequities. Using the socio-ecological model and the social determinants …

Population-Level Prevalence Of Depression And Summary Statistics Of Women With At Least A Year Post-Final Menstruation With And Without Hysterectomy, Happiness Kingi

Capstone Experience: Master of Public Health

Background: Depression is associated with estrogen hormonal changes. There are few comparisons studies on the population-level prevalence of depression in women at least a year post final menstruation with and without hysterectomy.

Objectives: 1) To determine the population-level prevalence of depression in women with at least a year post final menstruation with and without hysterectomy and 2) to calculate the summary statistics of women with at least a year post final menstruation with and without hysterectomy

Methods: A population-based cross-sectional design was used. Respondents were female participants of the U.S. National Health and Nutrition Examination Survey (NHANES) …

Defining The Epidemiology Of Safety Risks In Neonatal Intensive Care Unit Patients Requiring Surgery, Daniel J France, Jason Slagle, Emma Schremp, Sarah Moroz, L Dupree Hatch, Peter Grubb, Timothy J Vogus, Matthew S Shotwell, Amanda Lorinc, Christoph U Lehmann, Jamie Robinson, Marlee Crankshaw, Maria Sullivan, Timothy A Newman, Tamara Wallace, Matthew B Weinger, Martin L Blakely

Faculty, Staff and Student Publications

OBJECTIVE: The aim of the study was to determine the incidence, type, severity, preventability, and contributing factors of nonroutine events (NREs)-events perceived by care providers or skilled observers as a deviations from optimal care based on the clinical situation-in the perioperative (i.e., preoperative, operative, and postoperative) care of surgical neonates in the neonatal intensive care unit and operating room.

METHODS: A prospective observational study of noncardiac surgical neonates, who received preoperative and postoperative neonatal intensive care unit care, was conducted at an urban academic children's hospital between November 1, 2016, and March 31, 2018. One hundred twenty-nine surgical cases in …

Categorization And Frequency Of Indications For Packed Cell Transfusion In The Preterm Newborn During The Initial Hospital Stay At A Tertiary Care Hospital: A Cross-Sectional Study, Shirin Surani, Heeramani Lohana, Sheraz Ahmed, Rabia Hassan, Sapna Kewalani, Khalil Ahmed

Department of Paediatrics and Child Health

Introduction: Packed cell transfusion is a lifesaving procedure in premature babies as they have more complications as compared to babies who are born at term. Complications related to prematurity increase as gestational age decreases and anemia is one of the complications of prematurity which needs packed cell transfusions. To date, when to transfuse preterm babies and what would be the threshold for hemoglobin and hematocrit is still a point of argument as well as liberal versus restrictive transfusion protocols have been developed but what should be followed still needs more data. In our study, we have observed frequencies of different …

Improving Maternal And Child Health In Pakistan: A Programme Evaluation Using A Difference In Difference Analysis, Muhammad Ashar Malik, Lara Riedige Rohm, Pieter Van Baal, Eddy Van Doorslaer Van Doorslaer

Community Health Sciences

Introduction: Pakistan is a country with high maternal and infant mortality. Several large foreign funded projects were targeted at improving maternal, neonatal and child health. The Norway-Pakistan Partnership Initiative (NPPI) was one of these projects. This study aims to evaluate whether NPPI was successful in improving access and use of skilled maternal healthcare.
Methods: We used data from three rounds (2009-2010, 2011-2012 and 2013-2014) of the Pakistan Social and Living Standards Measurement Survey (PSLM). A difference-in-difference regression framework was used to estimate the effectiveness of NPPI and its different programme components with respect to maternal healthcare seeking behaviour of pregnant …

Full Breastfeeding Protection Against Common Enteric Bacteria And Viruses: Results From The Mal-Ed Cohort Study, Benjamin J J. Mccormick, Stephanie A. Richard, Laura E. Murray-Kolb, Gagandeep Kang, Aldo A M. Lima, Estomih Mduma, Margaret N. Kosek, Elizabeth T Rogawski Mcquade, Eric R. Houpt, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Breastfeeding is known to reduce risk of enteropathogen infections, but protection from specific enteropathogens is not well characterized.
Objective: To estimate the association between full breastfeeding (days fed breast milk exclusively or with non-nutritive liquids) and enteropathogen detection.
Design: 2,145 newborns were enrolled in eight sites, of whom 1,712 had breastfeeding and key enteropathogen data through 6 months. We focused on eleven enteropathogens: adenovirus 40/41, norovirus, sapovirus, astrovirus, and rotavirus, enterotoxigenic Escherichia coli (ETEC), Campylobacter spp, and typical enteropathogenic E. coli as well as entero-aggregative E. coli, Shigella and Cryptosporidium. Logistic regression was used to estimate the risk of …

Micronutrient Supplements Can Promote Disruptive Protozoan And Fungal Communities In The Developing Infant Gut, Ana Popovic, Celine Bourdon, Pauline W. Wang, David S. Guttman, Sajid Bashir Soofi, Zulfiqar Ahmed Bhutta, Robert H J. Bandsma, John Parkinson, Lisa G. Pell

Centre of Excellence in Women and Child Health

Supplementation with micronutrients, including vitamins, iron and zinc, is a key strategy to alleviate child malnutrition. However, association of gastrointestinal disorders with iron has led to ongoing debate over their administration. To better understand their impact on gut microbiota, we analyse the bacterial, protozoal, fungal and helminth communities of stool samples collected from a subset of 80 children at 12 and 24 months of age, previously enrolled into a large cluster randomized controlled trial of micronutrient supplementation in Pakistan (ClinicalTrials.gov identifier NCT00705445). We show that while bacterial diversity is reduced in supplemented children, vitamins and iron (as well as …

The Contribution Of Racism-Related Stress And Adversity To Disparities In Birth Outcomes: Evidence And Research Recommendations, Sabrina R. Liu, Laura M. Glynn

Psychology Faculty Articles and Research

Currently, racial and ethnic differences in adverse birth outcomes and infant mortality are some of the largest and most persistent health disparities in the United States. This narrative review article synthesizes existing literature to present a conceptual model of how racism-related stress and adversity are critical determinants of such disparities. We describe how historical and ongoing racism has created conditions wherein women of color are disproportionately exposed to chronic, multilayered stress and adversity and how the biological consequences of exposure to these stressors confers risk for adverse birth outcomes. Next, we identify important priorities and considerations for future research, including …