Maternal and Child Health Commons^™

Health And Socioeconomic Well-Being Of Young People Living With Hiv In Zambia: Evaluating The Zamfam Project, Project Soar

HIV and AIDS

The US Agency for International Development and US President’s Emergency Plan for AIDS Relief are supporting the Zambia Family (ZAMFAM) project to strengthen comprehensive, integrated service delivery and support to children living with, affected by, or vulnerable to HIV/AIDS in the Lusaka, Copperbelt, Southern, and Central Provinces of Zambia. Project SOAR is conducting a three-year prospective cohort study of young people living with (YPLHIV) and their primary caregivers/guardians in Central Province where the ZAMFAM project is being implemented, and in Eastern Province where there are no ongoing ZAMFAM activities for comparison. The information collected in the study focused on key …

Relationship Between Diet And Learning Differences In Children, Amelia Hamilton, Ramona Stone

Public Health Sciences Student Work

There is growing recognition that learning disabilities are associated with a variety of factors, including diet. Prior research showed that children in need of special education services eat less home prepared meals and more non-home-prepared meals, which can lead to obesity, inadequate diet, and lethargy. Additional research along with parental health education to promote healthy nutritional decisions and skills for preparing meals is necessary.

Overweight And Underserved In Children: A Contemporary American Paradox, Elyse J. Barletta-Sherwin, Ramona Stone

Public Health Sciences Student Work

• Childhood overweight and obesity trends are serious problems placing children at greater risks for adverse health outcomes and developmental issues.

• Between 2011 and 2014, obesity prevalence hovered near 17% for children 6-12 years.

• As of 2014, an estimated 14% of U.S. households were labeled food insecure, with 7.9 million children living within these underserved domains. In recent years, there has been growing concern that food insecurity and overweight and obesity conditions may be associated with each other, especially amongst children.

Insights And Evidence Gaps In Girl-Centered Programming: A Systematic Review, Nicole Haberland, Katharine Mccarthy, Martha Brady

Poverty, Gender, and Youth

Increased attention to the needs of adolescent girls has led to a growing number of programs in low- and middle-income countries. Questions remain, however, about what aspects of program design are most effective. This hinders efforts to effectively allocate resources, scale up programs, and replicate results across settings. This review looks at how the number of program components, involvement of supporting actors who influence the lives of girls, supplemental “booster” activities, intervention exposure level, and community saturation level influenced outcomes for girls. While findings suggest the importance of multicomponent programs and longer program exposure, each area requires further rigorous research …

The Effectiveness Of Interventions And Bundles For Central Line-Associated Bloodstream Infections In The Neonatal Intensive Care Unit, Mohamad Alhamwi

Honors Undergraduate Theses

Introduction: Central Line-Associated Bloodstream Infections (CLABSIs) are a major cause of increased mortality, morbidity and healthcare costs in neonatal intensive care units (NICUs) patients. Despite CDC's efforts to reduce infection rates, patients often suffer consequences. The objective of this study is to perform a systematic review of strategies utilized in the neonatal population and evaluate them with the current CDC's guidelines to assess the effectiveness of bundles in preventing CLABSI in NICUs.

Methods: A systematic literature search was conducted using CINAHL Plus with Text, Cochrane Database of Systematic Reviews and MEDLINE from January 2008 up to 2018. There were multiple …

Evaluating A Multidisciplinary Integrated Management Team Intervention To Improve Maternal And Child Outcomes And Hiv Service Uptake And Retention In Lesotho, Project Soar

HIV and AIDS

Pregnant and postpartum HIV-positive women face a particularly complex set of barriers to prevention of mother-to-child transmission of HIV (PMTCT) uptake at the policy, health facility, community, and individual levels. They are vulnerable to poor retention in care and adherence to treatment, especially in the first three months after initiation of treatment and the postpartum period. In addition, counseling and support for primary prevention among HIV-negative pregnant women is almost nonexistent in PMTCT programs. This brief describes the IMPROVE study—a multidisciplinary integrated management team intervention to increase maternal and child health and HIV service uptake and retention—that Project SOAR is …

Root-Cause Analysis Of Persistently High Maternal Mortality In A Rural District Of Indonesia: Role Of Clinical Care Quality And Health Services Organizational Factors, Mohammad Afzal Mahmood, Ismi Mufidah, Steven Scroggs, Amna Rehana Siddiqui, Hafsa Raheel, Koentijo Wibdarminto, Bernardus Dirgantoro, Jorien Vercruyssen, Hayfaa A. Wahabi

Community Health Sciences

Background: Despite significant reduction in maternal mortality, there are still many regions in the world that suffer from high mortality. District Kutai Kartanegara, Indonesia, is one such region where consistently high maternal mortality was observed despite high rate of delivery by skilled birth attendants.
Method: Thirty maternal deaths were reviewed using verbal autopsy interviews, terminal event reporting, medical records' review, and Death Audit Committee reports, using a comprehensive root-cause analysis framework including Risk Identification, Signal Services, Emergency Obstetrics Care Evaluation, Quality, and 3 Delays.
Findings: The root causes were found in poor quality of care, which caused …

Wic Participation And Breastfeeding After The 2009 Wic Revision: A Propensity Score Approach, Kelin Li, Ming Wen, Megan Reynolds, Qi Zhang

Community & Environmental Health Faculty Publications

In this study, we examined the association between participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and breastfeeding outcomes before and after the 2009 revisions. Four-thousand-three-hundred-and-eight WIC-eligible children younger than 60 months were included from the 2005-2014 National Health and Nutrition Examination Survey (NHANES). We compared two birth cohorts with regard to their associations between WIC participation and being ever-breastfed and breastfed at 6 months. We estimated the average effect of the treatment for the treated to assess the causal effect of WIC participation on breastfeeding based on propensity score matching. The results showed that …

Exploring Barriers And Opportunities For Pre-Eclampsia And Eclampsia Prevention And Management In Ethiopia, Pooja Sripad, Hussein Ismail, Amy Dempsey, Karen Kirk, Charlotte E. Warren

Reproductive Health

The Ending Eclampsia Project is a five-year cooperative agreement between the United States Agency for International Development (USAID) and the Population Council, in partnership with the Federal Ministry of Health Ethiopia, which seeks to expand access to quality underutilized interventions and commodities for the prevention and treatment of pre-eclampsia/eclampsia (PE/E). This report presents qualitative findings from formative research conducted to: 1) assess the policy and health systems environment related to PE/E prevention and management, 2) identify potential bottlenecks in the supply chain, 3) investigate PE/E knowledge, attitudes, and practices at policy, health system, and community levels, 4) describe the barriers …

Adolescent Girls Empowerment Program (Agep): Endline Results—Executive Summary, Population Council

Poverty, Gender, and Youth

Adolescent girls in Zambia face a range of risks and vulnerabilities that challenge their healthy development from girls into young women, and they often lack the social, health, and economic assets that are necessary to mitigate these risks. The issues that confront vulnerable girls—high rates of gender-based violence, unsafe sex that puts girls at risk for unwanted pregnancies and HIV infections, school dropout, lack of economic resources and income-generating options, and lack of agency and participation—are interdependent and have similar causes. The vulnerabilities confronting Zambian adolescent girls formed the basis for designing the Adolescent Girls Empowerment Program (AGEP), which 1) …

Adolescent Girls Empowerment Program (Agep): Financial Literacy And Savings—Two-Year Follow-Up, Karen Austrian, Erica Soler-Hampejsek, Natalie Jackson Hachonda, Paul C. Hewett

Poverty, Gender, and Youth

Through the Adolescent Girls Empowerment Program (AGEP), the Population Council and partners implemented a social, health, and economic asset-building program in Zambia for over 11,000 vulnerable adolescent girls aged 10–19 years. The AGEP intervention was comprised of three major components: 1) weekly safe spaces groups in which girls met once a week for two years for training on sexual and reproductive health, life skills, and financial education; 2) a health voucher that girls could use at contracted private and public facilities for general wellness and sexual and reproductive health services; and 3) a savings account that was designed by the …

Adolescent Girls Empowerment Program (Agep): Nutrition, Paul C. Hewett, Amanda L. Willig, Jean Digitale, Erica Soler-Hampejsek, Natalie Jackson Hachonda, Jere R. Behrman, Karen Austrian

Poverty, Gender, and Youth

Adolescence is a critical period in the lives of young people and potentially a time to reap lasting benefits from interventions that improve general, sexual, nutritional, and maternal and child health. The government of Zambia is committed to improving the nutritional status of adolescents and pregnant women and their children. Nonetheless, adolescent girls in Zambia remain at risk for macro- and micro-nutrient deficiencies that have deleterious effects on growth, development, and maternal and child health. The Adolescent Girls Empowerment Program (AGEP) nutritional curriculum, developed in partnership with PATH, was tailored to provide age-appropriate information and covered six sessions on nutrition. …

The Hold Me Tight Program For Couples Becoming Parents: A Mixed Methods Study, Debbie Wang

Theses and Dissertations (Comprehensive)

ABSTRACT

Attachment theory has made substantial contributions to the understanding of close relationships. The purpose of this study was to inquire whether an attachment-informed psychoeducational program is a feasible and effective intervention for couples expecting their first child. The overarching question was: Is an attachment-informed relationship enhancement program, such as Hold Me Tight^® (HMT), helpful to couples in strengthening their relationship and increasing their confidence in becoming first-time parents? The research question was addressed using a mixed-methods approach.

In the first phase, the Hold Me Tight^® program developed by Dr. Sue Johnson was modified for use with couples …

Whether, When, And How: Fertility Intentions And Age In The U.S., Andrea Melnikas

Dissertations and Theses

Thinking about, planning for, and having children is a deeply personal experience influenced by myriad factors at individual, intrapersonal, community and larger social levels. Examining fertility intentions is of interest to researchers from numerous social science disciplines in part because these intentions are potentially tied to larger demographic and economic shifts. In recent years in the U.S. the mean age at first birth has been increasing, with more women of older ages (age 35 and older) giving birth, due to both delays in childbearing that accompanied larger social trends such as increased educational and career opportunities and a decrease in …

Environmental Exposure To Atrazine And Birth Defects: An Ecological Study In Kentucky, 2005-2014, Maria Dimitrios Politis

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Atrazine is one of the most widely used pesticides in the United States. Studies have shown that pesticides, in particular herbicides such as atrazine, may be associated with birth defects. The purpose of this study is to evaluate the association between potential environmental exposures to atrazine in water systems and prevalence rates of birth defects for the state of Kentucky. An ecological study using the Kentucky Birth Defects Registry Surveillance and the Kentucky Geological Survey databases from 2005 to 2014 was conducted. Poisson regression was used to estimate crude and adjusted rate ratios of the association between agricultural exposure metrics …

Incredible Years (Iy) Parents & Babies Well-Baby Program: Expanding The Reach Through Cultural Adaptation, Ayanda Chakawa, Briana Woods-Jaeger

Posters

No abstract provided.

Adolescent Girls Empowerment Program (Agep), Population Council

Poverty, Gender, and Youth

For Zambian girls, social isolation, economic vulnerability, and lack of appropriate health information and services are critical problems that prevent a healthy transition from girlhood to womanhood. The challenges that girls are confronted with—high rates of gender-based violence, unsafe sex that puts them at risk for unwanted pregnancy and HIV infection, school dropout, lack of economic resources and income-generating options, lack of agency and participation—are linked together through their root causes. Through the Adolescent Girls Empowerment Program (AGEP), the Population Council and partners implemented a social, health, and economic asset-building program for vulnerable adolescent girls in Zambia. This brief summarizes …

Child Domestic Work And Transitions To Commercial Sexual Exploitation: Evidence From Ethiopia, Annabel Erulkar

Poverty, Gender, and Youth

There are an estimated 17.2 million child domestic workers in the world, and the vast majority are girls. Domestic work keeps children out of school, confined to the home, socially isolated, and burdened with excessive domestic duties. Furthermore, evidence is emerging that domestic work is a feeder profession for sex work. In 2015–16, the Population Council undertook a study of migrant, out-of-school girls in Ethiopia. The domestic work conditions described in this brief create unbearable conditions for girls who enter into commercial sex work as an alternative, hoping for an improvement in their work situation. The study found that a …

Accelerating Action To End Child Marriage In Bangladesh, Sajeda Amin, Jyotirmoy Saha, Masuma Billah, Nargis Sultana, Eashita Haque, Surojit Kundu

Poverty, Gender, and Youth

Despite considerable social and economic progress in Bangladesh, child marriage remains the norm. The Population Council is partnering with UNFPA and the Ministry of Women and Children Affairs to empower girls with gender, life, and livelihood skills, and to engage communities to address fundamental normative drivers of child marriage. The objective of the baseline study is to generate a set of indicators against which change can be measured, and to provide specific information about the status of adolescents in the study area in ways that can guide intervention strategies and inform programs and policies. Baseline findings will provide a benchmark …

Las Uniones Infantiles Forzadas: De La Reforma Legal A La Disrupción Social—Investigación Formativa En Cinco Comunidades En Chisec Alta Verapaz, Paola Broll, Cecilia Garcés

Poverty, Gender, and Youth

La evidencia ha demostrado que el matrimonio y las uniones infantiles forzadas (M/UIF) son nocivos a los derechos y el desarrollo de las niñas y adolescentes. También se ha demostrado que aumentar la edad mínima del matrimonio no es suficiente para erradicar este fenómeno que subyace en la práctica de las instituciones sociales a nivel comunitario. Se ha realizada esta investigación en el momento en que se aprobó la modificación al Código Civil, seguido de una modificación para aumentar la edad mínima para el matrimonio en Guatemala, con el propósito de identificar las normas, prácticas, y actitudes vigentes en la …