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Sample records for community-based skilled birth

  1. Opportunities and challenges in implementing community based skilled birth attendance strategy in Kenya.

    Science.gov (United States)

    Mannah, Margaret Titty; Warren, Charlotte; Kuria, Shiphrah; Adegoke, Adetoro A

    2014-08-15

    Availability of skilled care at birth remains a major problem in most developing countries. In an effort to increase access to skilled birth attendance, the Kenyan government implemented the community midwifery programme in 2005. The aim of this programme was to increase women's access to skilled care during pregnancy, childbirth and post-partum within their communities. Qualitative research involving in-depth interviews with 20 community midwives and six key informants. The key informants were funder, managers, coordinators and supervisors of the programme. Interviews were conducted between June to July, 2011 in two districts in Western and Central provinces of Kenya. Findings showed major challenges and opportunities in implementing the community midwifery programme. Challenges of the programme were: socio-economic issues, unavailability of logistics, problems of transportation for referrals and insecurity. Participants also identified the advantages of having midwives in the community which were provision of individualised care; living in the same community with clients which made community midwives easily accessible; and flexible payment options. Although the community midwifery model is a culturally acceptable method to increase skilled birth attendance in Kenya, the use of skilled birth attendance however remains disproportionately lower among poor mothers. Despite several governmental efforts to increase access and coverage of delivery services to the poor, it is clear that the poor may still not access skilled care even with skilled birth attendants residing in the community due to several socio-economic barriers.

  2. Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana.

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    Fiifi Amoako Johnson

    Full Text Available The Community-based Health Planning and Services (CHPS initiative is a major government policy to improve maternal and child health and accelerate progress in the reduction of maternal mortality in Ghana. However, strategic intelligence on the impact of the initiative is lacking, given the persistant problems of patchy geographical access to care for rural women. This study investigates the impact of proximity to CHPS on facilitating uptake of skilled birth care in rural areas.Data from the 2003 and 2008 Demographic and Health Survey, on 4,349 births from 463 rural communities were linked to georeferenced data on health facilities, CHPS and topographic data on national road-networks. Distance to nearest health facility and CHPS was computed using the closest facility functionality in ArcGIS 10.1. Multilevel logistic regression was used to examine the effect of proximity to health facilities and CHPS on use of skilled care at birth, adjusting for relevant predictors and clustering within communities. The results show that a substantial proportion of births continue to occur in communities more than 8 km from both health facilities and CHPS. Increases in uptake of skilled birth care are more pronounced where both health facilities and CHPS compounds are within 8 km, but not in communities within 8 km of CHPS but lack access to health facilities. Where both health facilities and CHPS are within 8 km, the odds of skilled birth care is 16% higher than where there is only a health facility within 8km.Where CHPS compounds are set up near health facilities, there is improved access to care, demonstrating the facilitatory role of CHPS in stimulating access to better care at birth, in areas where health facilities are accessible.

  3. Birthing Support and the Community-Based Doula

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    Abramson, Rachel; Breedlove, Ginger K.; Isaacs, Beth

    2007-01-01

    This article is excerpted from the authors' "The Community-Based Doula: Supporting Families Before, During, and After Childbirth", published in 2006 by "ZERO TO THREE." In the U.S., many new parents are socially isolated and lack access to ongoing caring and support because of poverty, immigration, language barriers, or the growing mobility and…

  4. Determinants of skilled attendance for delivery in Northwest Ethiopia: a community based nested case control study

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    Mengesha Zelalem Birhanu

    2013-02-01

    Full Text Available Abstract Background The fifth Millennium Development Goal calls for a reduction of maternal mortality ratio by 75% between 1990 and 2015. A key indicator to measure this goal is the proportion of births attended by skilled health personnel. The maternal mortality ratio of Ethiopia is 676 deaths per 100,000 live births. Skilled birth attendance is correlated with lower maternal mortality rates globally and in Sub-Saharan Africa. However, the proportion of births with a skilled attendant is only 10% in Ethiopia. Therefore identifying the determinants of skilled attendance for delivery is a priority area to give policy recommendations. Methods A community based nested case control study was conducted from October 2009 – August 2011 at the University of Gondar health and demographic surveillance systems site located at Dabat district, Northwest Ethiopia. Data were obtained from the infant mortality prospective follow up study conducted to identify the determinants of infant survival. A pretested and structured questionnaire via interview was used to collect data on the different variables. Logistic regression analysis was used to identify the determinants of skilled birth attendance. Strength of the association was assessed using odds ratio with 95% CI. Results A total of 1065 mothers (213 cases and 852 controls were included in the analysis. Among the cases, 166 (77.9% were from urban areas. More than half (54% of the cases have secondary and above level of education. Secondary and above level of education [AOR (95%CI = 2.8 (1.29, 3.68] and urban residence [AOR (95%CI = 8.8 (5.32, 14.46] were associated with skilled attendance for delivery. Similarly, women who had ANC during their pregnancy four or more times [AOR (95%CI = 2.8 (1.56, 4.98] and who own TV [AOR (95%CI = 2.5 (1.32, 4.76] were more likely to deliver with the assistance of a skilled attendant. Conclusions Women’s education, place of residence, frequency of antenatal

  5. Anthropometric surrogates for screening of low birth weight newborns: a community-based study.

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    Rustagi, Neeti; Prasuna, J G; Taneja, D K

    2012-03-01

    In developing countries, where about 75% of births occur at home or in the community, logistic problems prevent the weighing of every newborn child. This study compares various anthropometric surrogates for identification of low birth weight neonates. A longitudinal community based study was done in an urban resettlement colony and 283 singleton neonates within 7 days of birth were examined for the anthropometric measurements such as head, chest, mid upper arm circumference and foot length as a screening tool for low birth weight. Chest circumference measured within 7 days of birth appeared to be the most appropriate surrogate of low birth weight with highest sensitivity (75.4%), specificity (78.4%), and positive predictive value (48.9%) as compared with other anthropometric parameters. Low birth weight neonates in absence of weighing scales can be early identified by using simple anthropometric measurements for enhanced home-based care and timely referral.

  6. Birth Spacing of Pregnant Women in Nepal: A Community-Based Study.

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    Karkee, Rajendra; Lee, Andy H

    2016-01-01

    Optimal birth spacing has health advantages for both mother and child. In developing countries, shorter birth intervals are common and associated with social, cultural, and economic factors, as well as a lack of family planning. This study investigated the first birth interval after marriage and preceding interbirth interval in Nepal. A community-based prospective cohort study was conducted in the Kaski district of Nepal. Information on birth spacing, demographic, and obstetric characteristics was obtained from 701 pregnant women using a structured questionnaire. Logistic regression analyses were performed to ascertain factors associated with short birth spacing. About 39% of primiparous women gave their first child birth within 1 year of marriage and 23% of multiparous women had short preceding interbirth intervals (birth spacing among the multiparous group was 44.9 (SD 21.8) months. Overall, short birth spacing appeared to be inversely associated with advancing maternal age. For the multiparous group, Janajati and lower caste women, and those whose newborn was female, were more likely to have short birth spacing. The preceding interbirth interval was relatively long in the Kaski district of Nepal and tended to be associated with maternal age, caste, and sex of newborn infant. Optimal birth spacing programs should target Janajati and lower caste women, along with promotion of gender equality in society.

  7. Birth spacing of pregnant women in Nepal: A community-based study

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    Rajendra Karkee

    2016-09-01

    Full Text Available BackgroundOptimal birth spacing has health advantages for both mother and child. In developing countries, shorter birth intervals are common and associated with social, cultural and economic factors, as well as a lack of family planning. This study investigated the first birth interval after marriage and preceding interbirth interval in Nepal.MethodsA community-based prospective cohort study was conducted in the Kaski district of Nepal. Information on birth spacing, demographic and obstetric characteristics was obtained from 701 pregnant women using a structured questionnaire. Logistic regression analyses were performed to ascertain factors associated with short birth spacing.ResultsAbout 39% of primiparous women gave their first child birth within one year of marriage and 23% of multiparous women had short preceding interbirth intervals (<24 months. The average birth spacing among the multiparous group was 44.9 (SD 21.8 months. Overall, short birth spacing appeared to be inversely associated with advancing maternal age.For the multiparous group, Janajati and lower caste women, and those whose newborn was female, were more likely to have short birth spacing.ConclusionsThe preceding interbirth interval was relatively long in the Kaski district of Nepal and tended to be associated with maternal age, caste, and sex of newborn infant. Optimal birth spacing programs should target Janajati and lower caste women, along with promotion of gender equality in society.

  8. Maternal mortality in rural south Ethiopia: outcomes of community-based birth registration by health extension workers.

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    Yaliso Yaya

    Full Text Available Rural communities in low-income countries lack vital registrations to track birth outcomes. We aimed to examine the feasibility of community-based birth registration and measure maternal mortality ratio (MMR in rural south Ethiopia.In 2010, health extension workers (HEWs registered births and maternal deaths among 421,639 people in three districts (Derashe, Bonke, and Arba Minch Zuria. One nurse-supervisor per district provided administrative and technical support to HEWs. The primary outcomes were the feasibility of registration of a high proportion of births and measuring MMR. The secondary outcome was the proportion of skilled birth attendance. We validated the completeness of the registry and the MMR by conducting a house-to-house survey in 15 randomly selected villages in Bonke.We registered 10,987 births (81·4% of expected 13,492 births with annual crude birth rate of 32 per 1,000 population. The validation study showed that, of 2,401 births occurred in the surveyed households within eight months of the initiation of the registry, 71·6% (1,718 were registered with similar MMRs (474 vs. 439 between the registered and unregistered births. Overall, we recorded 53 maternal deaths; MMR was 489 per 100,000 live births and 83% (44 of 53 maternal deaths occurred at home. Ninety percent (9,863 births were at home, 4% (430 at health posts, 2·5% (282 at health centres, and 3·5% (412 in hospitals. MMR increased if: the male partners were illiterate (609 vs. 346; p= 0·051 and the villages had no road access (946 vs. 410; p= 0·039. The validation helped to increase the registration coverage by 10% through feedback discussions.It is possible to obtain a high-coverage birth registration and measure MMR in rural communities where a functional system of community health workers exists. The MMR was high in rural south Ethiopia and most births and maternal deaths occurred at home.

  9. Teaching Interpersonal Skills to Psychiatric Outpatients: Using Structured Learning Therapy in a Community-Based Setting

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    Sprafkin, Robert P.; And Others

    1978-01-01

    The Structured Learning Therapy (SLT), a type of treatment used to assist psychiatric patients to learn skills they need for effective and satisfying living in the community, is described in this article. A description of the community-based treatment facility in which SLT may be utilized and the results of the evaluation studies are also…

  10. Birth Preparedness and Its Association with Skilled Birth Attendance and Postpartum Checkups among Mothers in Gibe Wereda, Hadiya Zone, South Ethiopia

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    Yohannes Lakew

    2016-01-01

    Full Text Available Background. Birth preparedness program was designed to enhance skilled birth attendance and postpartum checkups of women in a developing country to reduce the three delays that lead women and neonates to death and disability. However, the relationship between birth preparedness with skilled birth attendance and postpartum checkups among mothers is not well studied. Therefore this study is intended to assess the association between birth preparedness and skilled birth attendance and postpartum checkups. Methods. A community based cross-sectional study was conducted from March to April 2014. Eight out of 22 Kebeles were selected using probability proportional to size sampling method. Seven hundred and forty-five mothers were selected randomly from the sampling frame, generated from family folders obtained from health posts. Data was collected using pretested questionnaire by face-to-face interview. Data was entered into EpiData version 3.1 database and analyzed by SPSS version 16. Result. Out of 745 sampled mothers 728 (97.7% participated in the study. One hundred and twelve (15.4% and 128 (17.6% mothers got skilled birth attendance and received postpartum checkups for their last child, respectively. Birth preparedness, educational status of women and their husbands, and antenatal care visits of mothers were found to be predictor of skilled birth attendance and postpartum checkups. Mothers well prepared for child birth were 6.7 times more likely to attend skilled birth attendance [AOR = 6.7 (2.7–16.4] and 3 times more likely to follow postpartum checkups [AOR = 3.0 (1.5–5.9] than poorly prepared mothers, respectively. Travel time to reach the nearest health facility was found as predictor for postpartum checkups of mothers; mothers who travel ≤ 2 hours were three times more likely to follow postpartum checkups than mothers who travel > 2 hours (AOR (95% CI = 3.4 (1.5–7.9. Conclusion and Recommendation. Skilled birth attendance and

  11. Motivational intervention to reduce rapid subsequent births to adolescent mothers: a community-based randomized trial.

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    Barnet, Beth; Liu, Jiexin; DeVoe, Margo; Duggan, Anne K; Gold, Melanie A; Pecukonis, Edward

    2009-01-01

    One-quarter of adolescent mothers bear another child within 2 years, compounding their risk of poorer medical, educational, economic, and parenting outcomes. Most efforts to prevent rapid subsequent birth to teenagers have been unsuccessful but have seldom addressed motivational processes. We conducted a randomized trial to determine the effectiveness of a computer-assisted motivational intervention (CAMI) in preventing rapid subsequent birth to adolescent mothers. Pregnant teenagers (N = 235), aged 18 years and older who were at more than 24 weeks' gestation, were recruited from urban prenatal clinics serving low-income, predominantly African American communities. After completing baseline assessments, they were randomly assigned to 3 groups: (1) those in CAMI plus enhanced home visit (n = 80) received a multi-component home-based intervention (CAMI+); (2) those in CAMI-only (n = 87) received a single component home-based intervention; (3) and those in usual-care control (n = 68) received standard usual care. Teens in both intervention groups received CAMI sessions at quarterly intervals until 2 years' postpartum. Those in the CAMI+ group also received monthly home visits with parenting education and support. CAMI algorithms, based on the transtheoretical model, assessed sexual relationships and contraception-use intentions and behaviors, and readiness to engage in pregnancy prevention. Trained interventionists used CAMI risk summaries to guide motivational interviewing. Repeat birth by 24 months' postpartum was measured with birth certificates. Intent-to-treat analysis indicated that the CAMI+ group compared with the usual-care control group exhibited a trend toward lower birth rates (13.8% vs 25.0%; P = .08), whereas the CAMI-only group did not (17.2% vs 25.0%; P = .32). Controlling for baseline group differences, the hazard ratio (HR) for repeat birth was significantly lower for the CAMI+ group than it was with the usual-care group (HR = 0.45; 95% CI, 0

  12. Factors affecting birth weight of a newborn--a community based study in rural Karnataka, India.

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    Chandra S Metgud

    Full Text Available BACKGROUND: Low birth weight (LBW is a major public health problem in many developing countries, especially so in India. Although we do not know all the causes of LBW, maternal and environmental factors appear to be significant risk factors in its occurrence. OBJECTIVES: To know the factors affecting the birth weight of a newborn and to estimate the prevalence of LBW. METHODS: The present study was carried out amongst 1138 pregnant women and their newborns residing in area covered by Kinaye Primary Health Centre in rural Karnataka, India. The study was conducted from 1(st June 2008 to 31(st December 2009. RESULTS: The mean birth weight of newborns was 2.6 kg with a range of 1.2 to 3.8 kg. The prevalence of LBW was 22.9%. Among the studied risk factors, 25 of them were significantly associated with the birth weight of a newborn on univariate logistic regression analysis. Maternal education [Odds Ratio (OR 3.2], exposure to passive smoking [OR 2.3], age at first pregnancy ≥25 years [OR 3.6], birth interval <2 years [OR 2.4], previous history of LBW baby [OR 3.3], weight gain ≤4 kg during pregnancy [OR 7.0], maternal weight at last week of gestation ≤45 kg [OR 2.3], pregnancy induced hypertension [OR 3.3], high risk pregnancy [OR 3.6] and late antenatal registration [OR 3.6] emerged as significant risk factors on multivariate analysis. CONCLUSION: The problem of LBW is multidimensional, and hence, we need an integrated approach incorporating medical, social, economical and educational measures to address this issue.

  13. Racism, health status, and birth outcomes: results of a participatory community-based intervention and health survey.

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    Carty, Denise C; Kruger, Daniel J; Turner, Tonya M; Campbell, Bettina; DeLoney, E Hill; Lewis, E Yvonne

    2011-02-01

    Many community-based participatory research (CBPR) partnerships address social determinants of health as a central consideration. However, research studies that explicitly address racism are scarce in the CBPR literature, and there is a dearth of available community-generated data to empirically examine how racism influences health disparities at the local level. In this paper, we provide results of a cross-sectional, population-based health survey conducted in the urban areas of Genesee and Saginaw Counties in Michigan to assess how a sustained community intervention to reduce racism and infant mortality influenced knowledge, beliefs, and experiences of racism and to explore how perceived racism is associated with self-rated health and birth outcomes. We used ANOVA and regression models to compare the responses of intervention participants and non-participants as well as African Americans and European Americans (N = 629). We found that intervention participants reported greater acknowledgment of the enduring and differential impact of racism in comparison to the non-intervention participants. Moreover, survey analyses revealed that racism was associated with health in the following ways: (1) experiences of racial discrimination predicted self-rated physical health, mental health, and smoking status; (2) perceived racism against one's racial group predicted lower self-rated physical health; and (3) emotional responses to racism-related experiences were marginally associated with lower birth-weight births in the study sample. Our study bolsters the published findings on perceived racism and health outcomes and highlights the usefulness of CBPR and community surveys to empirically investigate racism as a social determinant of health.

  14. Community-based distribution of misoprostol to prevent postpartum haemorrhage at home births: results from operations research in rural Ghana.

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    Geller, S; Carnahan, L; Akosah, E; Asare, G; Agyemang, R; Dickson, R; Kapungu, C; Owusu-Ansah, L; Robinson, N; Mensah-Homiah, J

    2014-02-01

    To report on a rigorous distribution and monitoring plan to track misoprostol for community-based distribution to reduce postpartum haemorrhage (PPH) in rural Ghana. Operations research. Rural Ghana. Women in third trimester of pregnancy presenting to primary health centres (PHCs) for antenatal care (ANC). Ghana Health Service (GHS), Millennium Village Projects, and the University of Illinois at Chicago conducted an operations research study designed to assess the safety, feasibility, and acceptability of community-based distribution of misoprostol to prevent PPH at home deliveries in rural Ghana. One thousand doses (3000 tablets, 200 μg each) were obtained from the Family Health Division of GHS. Three 200-μg tablets of misoprostol (600 μg) in foil packets were packaged together in secured transparent plastic packets labelled with pictorial messages and distributed to midwives at seven PHCs for distribution to pregnant women. Correct use of misoprostol in home deliveries and retrieval of unused misoprostol doses, PPH rates and maternal mortality. Of the 999 doses distributed to midwives, 982 (98.3%) were successfully tracked, with a 1.7% lost to follow-up rate. Midwives distributed 654 doses to women at third-trimester ANC visits. Of women who had misoprostol to use at home, 81% had an institutional delivery and were able to return the misoprostol safely to the midwife. Of the women that used misoprostol, 99% used the misoprostol correctly. This study clearly demonstrates that misoprostol distributed antenatally to pregnant women can be used accurately and reliably by rural Ghanaian women, and should be considered for policy implementation across Ghana and other countries with high home birth rates and maternal mortality ratios. © 2013 Royal College of Obstetricians and Gynaecologists.

  15. Intermittent preventive treatment of malaria in pregnancy: a community-based delivery system and its effect on parasitemia, anemia and low birth weight in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Bygbjerg, Ib; Magnussen, Pascal

    2008-01-01

    OBJECTIVE: The main objective of the study was to assess the impact of a community-based delivery system of intermittent preventive treatment (IPT) for malaria in pregnancy with sulfadoxine-pyrimethamine (SP) on access, parasitemia, anemia and low birth weight as primary outcome measures. METHODS.......0001). At both health units and the community-based approaches, IPT increased mean hemoglobin by 6.7% (panemia from 5.7% to 3.1% (p.... This intervention was acceptable to 89.6% of the women at the community-based approaches intending to use IPT in the future, while 48.1% of them had recommended it to other women. CONCLUSIONS: The community-based approaches increased access and adherence to IPT with an effect on anemia, severe anemia, parasitemia...

  16. Is there any role for community involvement in the community-based health planning and services skilled delivery program in rural Ghana?

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    Sakeah, Evelyn; McCloskey, Lois; Bernstein, Judith; Yeboah-Antwi, Kojo; Mills, Samuel; Doctor, Henry V

    2014-08-11

    In Ghana, between 1,400 and 3,900 women and girls die annually due to pregnancy related complications and an estimated two-thirds of these deaths occur in late pregnancy through to 48 hours after delivery. The Ghana Health Service piloted a strategy that involved training Community Health Officers (CHOs) as midwives to address the gap in skilled attendance in rural Upper East Region (UER). CHO-midwives collaborated with community members to provide skilled delivery services in rural areas. This paper presents findings from a study designed to assess the extent to which community residents and leaders participated in the skilled delivery program and the specific roles they played in its implementation and effectiveness. We employed an intrinsic case study design with a qualitative methodology. We conducted 29 in-depth interviews with health professionals and community stakeholders. We used a random sampling technique to select the CHO-midwives in three Community-based Health Planning and Services (CHPS) zones for the interviews and a purposive sampling technique to identify and interview District Directors of Health Services from the three districts, the Regional Coordinator of the CHPS program and community stakeholders. Community members play a significant role in promoting skilled delivery care in CHPS zones in Ghana. We found that community health volunteers and traditional birth attendants (TBAs) helped to provide health education on skilled delivery care, and they also referred or accompanied their clients for skilled attendants at birth. The political authorities, traditional leaders, and community members provide resources to promote the skilled delivery program. Both volunteers and TBAs are given financial and non-financial incentives for referring their clients for skilled delivery. However, inadequate transportation, infrequent supply of drugs, attitude of nurses remains as challenges, hindering women accessing maternity services in rural areas. Mutual

  17. Transition to Skilled Birth Attendance: Is There a Future Role for Trained Traditional Birth Attendants?

    OpenAIRE

    Sibley, Lynn M.; Sipe, Theresa Ann

    2006-01-01

    A brief history of training of traditional birth attendants (TBAs), summary of evidence for effectiveness of TBA training, and consideration of the future role of trained TBAs in an environment that emphasizes transition to skilled birth attendance are provided. Evidence of the effectiveness of TBA training, based on 60 studies and standard meta-analytic procedures, includes moderate-to-large improvements in behaviours of TBAs relating to selected intrapartum and postnatal care practices, sma...

  18. Skilled Birth Attendance in Nigeria: A Function of Frequency and ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Keywords: Antenatal care, skilled birth attendance, pregnancy, Nigeria. Résumé. Le taux .... Islam, or other/no religion); residence (urban vs. rural); region of .... South East. 9.7. 17.6. 2.2 ..... in Nigeria. Although there is evidence that male.

  19. The effect of providing skilled birth attendance and emergency obstetric care in preventing stillbirths

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    Lawn Joy E

    2011-04-01

    Full Text Available Abstract Background Of the global burden of 2.6 million stillbirths, around 1.2 million occur during labour i.e. are intrapartum deaths. In low-/middle-income countries, a significant proportion of women give birth at home, usually in the absence of a skilled birth attendant. This review discusses the impact of skilled birth attendance (SBA and the provision of Emergency Obstetric Care (EOC on stillbirths and perinatal mortality. Methods A systematic literature search was performed on PubMed/MEDLINE, Cochrane Database and the WHO regional libraries. Data of all eligible studies were extracted into a standardized Excel sheet containing variables such as participants’ characteristics, sample size, location, setting, blinding, allocation concealment, intervention and control details and limitations. We undertook a meta-analysis of the impact of SBA on stillbirths. Given the paucity of data from randomized trials or robust quasi-experimental designs, we undertook an expert Delphi consultation to determine impact estimates of provision of Basic and Comprehensive EOC on reducing stillbirths if there would be universal coverage (99%. Results The literature search yielded 871 hits. A total of 21 studies were selected for data abstraction. Our meta-analysis on community-based skilled birth attendance based on two before-after studies showed a 23% significant reduction in stillbirths (RR = 0.77; 95% CI: 0.69 – 0.85. The overall quality grade of available evidence for this intervention on stillbirths was ‘moderate’. The Delphi process supported the estimated reduction in stillbirths by skilled attendance and experts further suggested that the provision of Basic EOC had the potential to avert intrapartum stillbirths by 45% and with provision of Comprehensive EOC this could be reduced by 75%. These estimates are conservative, consistent with historical trends in maternal and perinatal mortality from both developed and developing countries, and are

  20. Impact of Birth Preparedness and Complication Readiness Interventions on Birth with a Skilled Attendant : A Systematic Review

    NARCIS (Netherlands)

    Miltenburg, Andrea Solnes; Roggeveen, Yadira; Shields, Laura; van Elteren, Marianne; van Roosmalen, Jos; Stekelenburg, Jelle; Portela, Anayda

    2015-01-01

    Background Increased preparedness for birth and complications is an essential part of antenatal care and has the potential to increase birth with a skilled attendant. We conducted a systematic review of studies to assess the effect of birth preparedness and complication readiness interventions on

  1. Impact of Birth Preparedness and Complication Readiness Interventions on Birth with a Skilled Attendant : A Systematic Review

    NARCIS (Netherlands)

    Miltenburg, Andrea Solnes; Roggeveen, Yadira; Shields, Laura; van Elteren, Marianne; van Roosmalen, Jos; Stekelenburg, Jelle; Portela, Anayda

    2015-01-01

    Background Increased preparedness for birth and complications is an essential part of antenatal care and has the potential to increase birth with a skilled attendant. We conducted a systematic review of studies to assess the effect of birth preparedness and complication readiness interventions on in

  2. Transition to skilled birth attendance: is there a future role for trained traditional birth attendants?

    Science.gov (United States)

    Sibley, Lynn M; Sipe, Theresa Ann

    2006-12-01

    A brief history of training of traditional birth attendants (TBAs), summary of evidence for effectiveness of TBA training, and consideration of the future role of trained TBAs in an environment that emphasizes transition to skilled birth attendance are provided. Evidence of the effectiveness of TBA training, based on 60 studies and standard meta-analytic procedures, includes moderate-to-large improvements in behaviours of TBAs relating to selected intrapartum and postnatal care practices, small significant increases in women's use of antenatal care and emergency obstetric care, and small significant decreases in perinatal mortality and neonatal mortality due to birth asphyxia and pneumonia. Such findings are consistent with the historical focus of TBA training on extending the reach of primary healthcare and a few programmes that have included home-based management of complications of births and the newborns, such as birth asphyxia and pneumonia. Evidence suggests that, in settings characterized by high mortality and weak health systems, trained TBAs can contribute to the Millennium Development Goal 4--a two-thirds reduction in the rate of mortality of children aged less than 14 years by 2015--through participation in key evidence-based interventions.

  3. Racism, Health Status, and Birth Outcomes: Results of a Participatory Community-Based Intervention and Health Survey

    OpenAIRE

    Carty, Denise C.; Kruger, Daniel J.; Turner, Tonya M.; Campbell, Bettina; DeLoney, E. Hill; Lewis, E. Yvonne

    2011-01-01

    Many community-based participatory research (CBPR) partnerships address social determinants of health as a central consideration. However, research studies that explicitly address racism are scarce in the CBPR literature, and there is a dearth of available community-generated data to empirically examine how racism influences health disparities at the local level. In this paper, we provide results of a cross-sectional, population-based health survey conducted in the urban areas of Genesee and ...

  4. Postnatal Care Service Utilization and Associated Factors among Women Who Gave Birth in the Last 12 Months prior to the Study in Debre Markos Town, Northwestern Ethiopia: A Community-Based Cross-Sectional Study

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    Miteku Andualem Limenih

    2016-01-01

    Full Text Available Improving maternal and newborn health through proper postnatal care services under the care of skilled health personnel is the key strategy to reduce maternal and neonatal mortality. However, there were limited evidences on utilization of postnatal care services in Ethiopia. A community based cross-sectional study was conducted in Debremarkos town, Northwest Ethiopia. Cluster sampling technique was used to select 588 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with postnatal care utilization. Odds ratio with 95% confidence interval was computed to determine the level of significance. Postnatal care service utilization was found to be 33.5%. Awareness about maternal complication (AOR: 2.72, 95% CI (1.71, 4.34, place of delivery of last child (AOR: 1.68, 95% CI: (1.01, 2.79, outcome of birth (AOR: 2.71, 95% CI (1.19, 6.19, delivery by cesarean section (AOR: 4.82, 95% CI (1.86, 12.54, and delivery complication that occurred during birth (AOR: 2.58, 95% CI (1.56, 4.28 were factors associated with postnatal care service utilization. Postnatal care service utilization was found to be low. Increasing awareness about postnatal care, preventing maternal and neonatal complication, and scheduling mothers based on the national postnatal care follow-up protocol would increase postnatal care service utilization.

  5. Skilled Birth Attendance among Women in Tharaka-Nithi County, Kenya

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    Eliphas Gitonga

    2017-01-01

    Full Text Available Background. The burden of maternal mortality is concentrated in sub-Saharan Africa with an estimation of 500 000 deaths annually. In 2012, about forty million births occurred without a skilled attendant in developing countries. Skilled birth attendance improves maternal and newborn survival. The aim of this study therefore was to establish the level of skilled birth attendance and the associated factors. Methods. A cross-sectional survey was carried out using structured questionnaires as tools of data collection. Systematic sampling was used to select the respondents from the facilities that were stratified. The dependent variable was skilled birth attendance. Descriptive statistics were used to generate proportions and percentages while chi-square and Fisher’s exact tests were used to draw inferences. Association was significant if P<0.05. Results. The level of utilisation of skilled birth attendance was 77%. Skilled birth attendance was noted to be associated with age, level of education, average family income, parity, distance to the health facility, timing of initiation of antenatal care, level of facility attended during pregnancy, and birth preparedness status. Conclusion. The level of skilled birth attendance among women in Tharaka-Nithi County, Kenya, despite being higher than in some counties, requires improvement.

  6. Infants delivered in maternity homes run by traditional birth attendants in urban Nigeria: a community-based study.

    Science.gov (United States)

    Olusanya, Bolajoko O; Inem, Victor A; Abosede, Olayinka A

    2011-06-01

    We explored factors associated with traditional maternity/herbal homes (TMHs) run by traditional birth attendants (TBAs) compared with hospital or home delivery in Lagos, Nigeria, and found that infants delivered at TMHs were less likely to have severe hyperbilirubinemia compared with infants delivered in hospitals or residential homes. These infants were also less likely to be preterm compared with those delivered in hospitals or undernourished compared with infants delivered in residential homes. We concluded that infants delivered at TMHs who survive are unlikely to be at greater risks of some adverse perinatal outcomes than those delivered in hospitals or family homes.

  7. Utilization of the state led public private partnership program "Chiranjeevi Yojana" to promote facility births in Gujarat, India: a cross sectional community based study.

    Science.gov (United States)

    Yasobant, Sandul; Vora, Kranti Suresh; Shewade, Hemant Deepak; Annerstedt, Kristi Sidney; Isaakidis, Petros; Mavalankar, Dileep V; Dholakia, Nishith B; De Costa, Ayesha

    2016-07-15

    "Chiranjeevi Yojana (CY)", a state-led large-scale demand-side financing scheme (DSF) under public-private partnership to increase institutional delivery, has been implemented across Gujarat state, India since 2005. The scheme aims to provide free institutional childbirth services in accredited private health facilities to women from socially disadvantaged groups (eligible women). These services are paid for by the state to the private facility with the intention of service being free to the user. This community-based study estimates CY uptake among eligible women and explores factors associated with non-utilization of the CY program. This was a community-based cross sectional survey of eligible women who gave birth between January and July 2013 in 142 selected villages of three districts in Gujarat. A structured questionnaire was administered by trained research assistant to collect information on socio-demographic details, pregnancy details, details of childbirth and out-of-pocket (OOP) expenses incurred. A multivariable inferential analysis was done to explore the factors associated with non-utilization of the CY program. Out of 2,143 eligible women, 559 (26 %) gave birth under the CY program. A further 436(20 %) delivered at free public facilities, 713(33 %) at private facilities (OOP payment) and 435(20 %) at home. Eligible women who belonged to either scheduled tribe or poor [aOR = 3.1, 95 % CI:2.4 - 3.8] or having no formal education [aOR = 1.6, 95 % CI:1.1, 2.2] and who delivered by C-section [aOR = 2.1,95 % CI: 1.2, 3.8] had higher odds of not utilizing CY program. Of births at CY accredited facilities (n = 924), non-utilization was 40 % (n = 365) mostly because of lack of required official documentation that proved eligibility (72 % of eligible non-users). Women who utilized the CY program overall paid more than women who delivered in the free public facilities. Uptake of the CY among eligible women was low after almost a decade

  8. Preterm Birth and Adult Wealth: Mathematics Skills Count.

    Science.gov (United States)

    Basten, Maartje; Jaekel, Julia; Johnson, Samantha; Gilmore, Camilla; Wolke, Dieter

    2015-10-01

    Each year, 15 million babies worldwide are born preterm. Preterm birth is associated with adverse neurodevelopmental outcomes across the life span. Recent registry-based studies suggest that preterm birth is associated with decreased wealth in adulthood, but the mediating mechanisms are unknown. This study investigated whether the relationship between preterm birth and low adult wealth is mediated by poor academic abilities and educational qualifications. Participants were members of two British population-based birth cohorts born in 1958 and 1970, respectively. Results showed that preterm birth was associated with decreased wealth at 42 years of age. This association was mediated by decreased intelligence, reading, and, in particular, mathematics attainment in middle childhood, as well as decreased educational qualifications in young adulthood. Findings were similar in both cohorts, which suggests that these mechanisms may be time invariant. Special educational support in childhood may prevent preterm children from becoming less wealthy as adults.

  9. Post-neonatal mortality, morbidity, and developmental outcome after ultrasound-dated preterm birth in rural Malawi: a community-based cohort study.

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    Melissa Gladstone

    2011-11-01

    Full Text Available BACKGROUND: Preterm birth is considered to be associated with an estimated 27% of neonatal deaths, the majority in resource-poor countries where rates of prematurity are high. There is no information on medium term outcomes after accurately determined preterm birth in such settings. METHODS AND FINDINGS: This community-based stratified cohort study conducted between May-December 2006 in Southern Malawi followed up 840 post-neonatal infants born to mothers who had received antenatal antibiotic prophylaxis/placebo in an attempt to reduce rates of preterm birth (APPLe trial ISRCTN84023116. Gestational age at delivery was based on ultrasound measurement of fetal bi-parietal diameter in early-mid pregnancy. 247 infants born before 37 wk gestation and 593 term infants were assessed at 12, 18, or 24 months. We assessed survival (death, morbidity (reported by carer, admissions, out-patient attendance, growth (weight and height, and development (Ten Question Questionnaire [TQQ] and Malawi Developmental Assessment Tool [MDAT]. Preterm infants were at significantly greater risk of death (hazard ratio 1.79, 95% CI 1.09-2.95. Surviving preterm infants were more likely to be underweight (weight-for-age z score; p<0.001 or wasted (weight-for-length z score; p<0.01 with no effect of gestational age at delivery. Preterm infants more often screened positively for disability on the Ten Question Questionnaire (p = 0.002. They also had higher rates of developmental delay on the MDAT at 18 months (p = 0.009, with gestational age at delivery (p = 0.01 increasing this likelihood. Morbidity-visits to a health centre (93% and admissions to hospital (22%-was similar for both groups. CONCLUSIONS: During the first 2 years of life, infants who are born preterm in resource poor countries, continue to be at a disadvantage in terms of mortality, growth, and development. In addition to interventions in the immediate neonatal period, a refocus on early childhood is

  10. Factors Affecting Utilization of Skilled Birth Attendants by Women in ...

    African Journals Online (AJOL)

    Medical Journal of Zambia ... utilization of the skilled delivery services and most TBAs are educating women on HIV/AIDs. ... The study also found that majority of the pregnant women take traditional herbs during pregnancy to quicken labour ...

  11. Skilled care at birth among rural women in Nepal: practice and challenges.

    Science.gov (United States)

    Dhakal, Sulochana; van Teijlingen, Edwin; Raja, Edwin Amalraj; Dhakal, Keshar Bahadur

    2011-08-01

    In Nepal, most births take place at home, and many, particularly in rural areas, are not attended by a skilled birth attendant. The main objectives of the study were to assess the use of skilled delivery care and barriers to access such care in a rural community and to assess health problems during delivery and seeking care. This cross-sectional study was carried out in two Village Development Committees in Nepal in 2006. In total, 150 women who had a live birth in the 24 months preceding the survey were interviewed using a structured questionnaire. The sample population included married women aged 15-49 years. Forty-six (31%) women delivered their babies at hospital, and 104 (69%) delivered at home. The cost of delivery at hospital was significantly (p access skilled delivery care were: distance to hospital, lack of transportation, lack of awareness on delivery care, and cost. The main reasons for seeking intrapartum care were long labour, retained placenta, and excessive bleeding. Only a quarter of women sought care immediately after problems occurred. The main reasons seeking care late were: the woman or her family not perceiving that there was a serious problem, distance to health facility, and lack of transport. The use of skilled birth attendants at delivery among rural women in Nepal is very poor. Home delivery by unskilled birth attendants is still a common practice among them. Many associated factors relating to the use of skilled delivery care that were identified included age, education and occupation of women, and education and occupation of husbands. Therefore, the availability of skilled delivery care services at the community, initiation of a primary health centre with skilled staff for delivery, and increasing awareness among women to seek skilled delivery care are the best solution.

  12. Birth order and communication skills of pharmacy students.

    Science.gov (United States)

    Murawski, M M; Miederhoff, P; Rule, W

    1995-06-01

    Pharmacy educators are training graduates in a concept of practice called pharmaceutical care. The movement towards patient care requires consideration of the personal and social qualities of trainees. All individuals attracted to pharmacy may not desire involvement in patient care. This preliminary study of pharmacy students of the relationships among birth order, empathy, and assertiveness behaviors using the Interpersonal Communication Inventory showed the incidence of firstborn students in this sample was not significantly higher than in the general population but the incidence of those born second was significantly lower. Regression analysis of individual items gave significant correlations between birth order and three items on the inventory. While few conclusions can be drawn, a clear direction for further research is indicated.

  13. Safe delivery care practices in western Nepal: Does women's autonomy influence the utilization of skilled care at birth?

    Science.gov (United States)

    Bhandari, Tulsi Ram; Kutty, V Raman; Sarma, P Sankara; Dangal, Ganesh

    2017-01-01

    Despite various efforts to increase the utilization of skilled birth attendants (SBA), nearly two-thirds of deliveries take place at home without the assistance of SBAs in Nepal. We hypothesized that the ability of women to take decisions about their own lives-women's autonomy-plays an important part in birth choices. To know this, we conducted a community-based cross-sectional study for assessing women's autonomy and utilization of safe delivery care service in Kapilvastu district of Nepal from June to October 2014. We used multivariate modeling to associate socioeconomic factors and women's autonomy with the utilization of safe delivery care services. Just over one-third of women sought institutional delivery care during the birth of their last child. Out of the total deliveries at health facilities, nearly 58% women visited health facility for self-reported emergency obstructive care. Only 6.2% home deliveries were handled by health workers and 14.7% women used the safe delivery kit for home delivery care. Higher levels of women's education had a strong positive association (odds ratio = 24.11, CI = 9.43-61.64) with institutional delivery care. Stratified analysis showed that when the husband is educated, women's education seems to work partly through their autonomy in decision making. Educational status of women emerged as one of the key predictors of the utilization of delivery care services in Kapilvastu district. Economic status of household and husband's education are other dominant predictors of the utilization of safe delivery care services. Improving the economic and educational status may be the way out for improving the proportion of institutional deliveries. Women's autonomy may be an important mediating factor in this pathway.

  14. pregnant women's perspectives on skilled birth attendance and ...

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    AJRH Managing Editor

    The present study utilized semi-structured interviews with 85 pregnant .... achieve successful outcome for mom and baby, cost, access, .... Caucasian-American female graduate student ... structured interview guide with open-ended ..... HC completed the open coding. ... W: The Skilled Attendance Index: Proposal for a new.

  15. Factors Affecting Utilization of Skilled Birth Attendants by Women in ...

    African Journals Online (AJOL)

    Esem

    ensure that the reasons for the loss of a child during or ... and reducing their death during this critical period .... skills), is the most common person assisting at a delivery. 7. (25%) . There are many unclear reasons as to why women may fail.

  16. Motor skill development in low-income, at-risk preschoolers: A community-based longitudinal intervention study.

    Science.gov (United States)

    Bellows, Laura L; Davies, Patricia L; Courtney, Jimikaye B; Gavin, William J; Johnson, Susan L; Boles, Richard E

    2017-04-26

    This study aimed to: (1) determine the status of fundamental movement skill (FMS) performance in low-income, at-risk preschoolers; and (2) evaluate the impact of the Food Friends Get Movin' with Mighty Moves (MM) program on improving children's FMS at two-year follow-up. Longitudinal, quasi-experimental study with matched controls. The Colorado LEAP study was conducted in four Head Start/preschools (two intervention, two control) serving children aged 3-5 years. MM was delivered to the intervention group during preschool. The Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) subtests for balance, running speed and agility, upper-limb coordination (object control (OC) skills) and strength were administered to children at baseline, post-intervention in preschool, one-year follow-up (kindergarten), and two-year follow-up (first grade). Compared to the normative sample's mean, the mean scaled score for all participants at baseline was significantly lower for balance (p=0.016) and OC skills (pskills for just the control group were significantly lower than those of the normative sample (p≤0.001). Hierarchical linear regression analyses revealed a significant intervention effect for OC skills with the overall model accounting for 41% of variance at two-year follow-up, F(6,165)=20.45, pskills, in at-risk elementary school children. Results suggest that at-risk preschoolers are already behind in FMS development and these delays will continue through first grade. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  17. Educating skilled birth attendants in Mexico: do the curricula meet international confederation of midwives standards?

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    Cragin, Leslie; DeMaria, Lisa M; Campero, Lourdes; Walker, Dilys M

    2007-11-01

    Although the majority of births in Mexico are attended by skilled birth attendants, maternal mortality remains moderately high, raising questions about the quality of training and delivery care. We conducted an exhaustive review of the curricula of three representative schools for the education and clinical preparation of three types of birth attendant - obstetric nurses, professional midwives and general physicians - National Autonomous University of Mexico (UNAM) School of Obstetric Nursing; CASA Professional Midwifery School; and UNAM School of Medicine, Iztacala Campus. All curricular materials were measured against the 214 indicators of knowledge and ability in the International Confederation of Midwives (ICM) skilled attendant training guidelines. The CASA curriculum covered 83% of the competencies, 93% of basic knowledge and 86% of basic abilities, compared with 54%, 59% and 64% for UNAM Obstetric Nursing School and 43%, 60% and 36% for UNAM School of Medicine, respectively. Neither the Obstetric Nursing School nor the School of Medicine documented the quantity or types of clinical experience required for graduation. General physicians attend the most births in Mexico, yet based on our analysis, professional midwives had the most complete education and training as measured against the ICM competencies. We recommend that professional midwives and obstetric nurses should be formally integrated into the public health system to attend deliveries.

  18. The APPLe study: a randomized, community-based, placebo-controlled trial of azithromycin for the prevention of preterm birth, with meta-analysis.

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    Nynke R van den Broek

    2009-12-01

    Full Text Available BACKGROUND: Premature birth is the major cause of perinatal mortality and morbidity in both high- and low-income countries. The causes of preterm labour are multiple but infection is important. We have previously described an unusually high incidence of preterm birth (20% in an ultrasound-dated, rural, pregnant population in Southern Malawi with high burdens of infective morbidity. We have now studied the impact of routine prophylaxis with azithromycin as directly observed, single-dose therapy at two gestational windows to try to decrease the incidence of preterm birth. METHODS AND FINDINGS: We randomized 2,297 pregnant women attending three rural and one peri-urban health centres in Southern Malawi to a placebo-controlled trial of oral azithromycin (1 g given at 16-24 and 28-32 wk gestation. Gestational age was determined by ultrasound before 24 wk. Women and their infants were followed up until 6 wk post delivery. The primary outcome was incidence of preterm delivery, defined as 6,200 pregnancies shows no effect on preterm birth (relative risk 1.02, 95% confidence interval 0.86-1.22. CONCLUSIONS: This study provides no support for the use of antibiotics as routine prophylaxis to prevent preterm birth in high risk populations; prevention of preterm birth requires alternative strategies. TRIAL REGISTRATION: Current Controlled Trials ISRCTN84023116

  19. Empowerment, intimate partner violence and skilled birth attendance among women in rural Uganda.

    Science.gov (United States)

    Kwagala, Betty; Nankinga, Olivia; Wandera, Stephen Ojiambo; Ndugga, Patricia; Kabagenyi, Allen

    2016-05-04

    There is limited research on how the empowerment of women and intimate partner violence (IPV) are associated with skilled birth attendance (SBA) among rural women in Uganda. Therefore, the aim of this paper was to investigate the association between women's empowerment, their experience of IPV and SBA in rural Uganda. Using data from the Uganda Demographic and Health Survey (UDHS), we selected 857 rural women who were in union, had given birth in the last 5 years preceding the survey and were selected for the domestic violence (DV) module. Frequency distributions were used to describe the background characteristics of the women and their partners. Pearson's chi-squared (χ (2)) tests were used to investigate the associations between SBA and women's empowerment; and partners' and women's socio-demographic factors including sexual violence. Multivariable logistic regression analyses were used to examine the association between SBA and explanatory variables. More than half (55 %) of the women delivered under the supervision of skilled birth attendant. Women's empowerment with respect to participation in household decision-making, property (land and house) (co)ownership, IPV, and sexual empowerment did not positively predict SBA among rural women in Uganda. Key predictors of SBA were household wealth status, partners' education, ANC attendance and parity. For enhancement of SBA in rural areas, there is a need to encourage a more comprehensive ANC attendance irrespective of number of children a woman has; and design interventions to enhance household wealth and promote men's education.

  20. Towards universal access to skilled birth attendance: the process of transforming the role of traditional birth attendants in Rural China.

    Science.gov (United States)

    Jiang, Hong; Qian, Xu; Chen, Lili; Li, Jian; Escobar, Erin; Story, Mary; Tang, Shenglan

    2016-03-21

    Institution-based childbirth, with the ultimate goal of universal access to skilled birth attendance (SBA), has been selected as a key strategy to reduce the maternal mortality rate in many developing countries. However, the question of how to engage traditional birth attendants (TBAs) in the advocacy campaign for SBA poses a number of challenges. This paper aims to demonstrate how TBAs in rural regions of China have been integrated into the health system under a policy of institutional delivery. Research was conducted through literature and document reviews and individual in-depth interviews with stakeholders of the safe motherhood program in rural Guangxi Zhuang Autonomous Region, China. A total of 33 individual interviews were conducted with regional and local politicians, policy makers, health managers, health providers, civil society members, village cadres for women affairs, former TBAs, village maternal health workers, mothers and their mother-in-laws. Since 1998, TBA's traditional role of providing in-home care during childbirth has been restructured and their social role has been strengthened in rural Guangxi. TBAs were redesigned to function as the linkage between women and the health system. A new policy in 1999 shifted the role of TBAs to village maternal health workers whose responsibilities were mainly to promote perinatal care and institution-based delivery of pregnant women. This successful transformation involved engaging with government and other actors, training TBAs for their new role, and providing incentives and sanctions for human resources management. The China experience of transforming the role of TBAs in Guangxi rural area is an example of successfully engaging TBAs in promoting institution-based childbirth.

  1. A Community-Based Intervention to Prevent Obesity Beginning at Birth among American Indian Children: Study Design and Rationale for the PTOTS Study

    Science.gov (United States)

    Karanja, Njeri; Aickin, Mikel; Lutz, Tam; Mist, Scott; Jobe, Jared B.; Maupome, Gerardo; Ritenbaugh, Cheryl

    2012-01-01

    Eating and physical activity behaviors associated with adult obesity have early antecedents, yet few studies have focused on obesity prevention interventions targeting very young children. Efforts to prevent obesity beginning at birth seem particularly important in populations at risk for early-onset obesity. National estimates indicate that…

  2. A Community-Based Intervention to Prevent Obesity Beginning at Birth among American Indian Children: Study Design and Rationale for the PTOTS Study

    Science.gov (United States)

    Karanja, Njeri; Aickin, Mikel; Lutz, Tam; Mist, Scott; Jobe, Jared B.; Maupome, Gerardo; Ritenbaugh, Cheryl

    2012-01-01

    Eating and physical activity behaviors associated with adult obesity have early antecedents, yet few studies have focused on obesity prevention interventions targeting very young children. Efforts to prevent obesity beginning at birth seem particularly important in populations at risk for early-onset obesity. National estimates indicate that…

  3. Skilled birth attendance: what does it mean and how can it be measured? A clinical skills assessment of maternal and child health workers in Nepal.

    Science.gov (United States)

    Carlough, M; McCall, M

    2005-05-01

    The presence of a skilled birth attendant at delivery is important in averting maternal and neonatal mortality and morbidity. It has now shown that even trained traditional birth attendants (TBAs) cannot, in most cases, save women's lives effectively because they are unable to treat complications, and are often unable to refer. Qualified midwives and doctors are often not available in the rural areas and community settings where most women in developing countries deliver. Defining the minimum competency level necessary to meet the definition of skilled birth attendant is important, particularly in countries such as Nepal with limited availability of facility-based emergency obstetric care. Maternal and child health workers are local women aged 18-35 who completed a 15-week course in maternal and child health. As the role of MCHWs has expanded to meet the country's needs for skilled attendance, a 6-week "refresher" course in midwifery skills is offered. The results of this clinical skills assessment of 104 randomly selected MCHWs from 15 districts across Nepal supports the premise that MCHWs with appropriate training have an acceptable level of knowledge and skill, demonstrated in a practice situation, to meet the definition of community level skilled birth attendants. Yet, competency alone will not necessarily improve the situation. To affect maternal mortality in Nepal, MCHWs must be widely available, they must be allowed to do what they are trained to do, and they must have logistical and policy support.

  4. Early developmental influences on self-esteem trajectories from adolescence through adulthood: Impact of birth weight and motor skills.

    Science.gov (United States)

    Poole, Kristie L; Schmidt, Louis A; Ferro, Mark A; Missiuna, Cheryl; Saigal, Saroj; Boyle, Michael H; Van Lieshout, Ryan J

    2017-04-20

    While the trajectory of self-esteem from adolescence to adulthood varies from person to person, little research has examined how differences in early developmental processes might affect these pathways. This study examined how early motor skill development interacted with preterm birth status to predict self-esteem from adolescence through the early 30s. We addressed this using the oldest known, prospectively followed cohort of extremely low birth weight (self-report, and self-esteem was reported during three follow-up periods (age 12-16, age 22-26, and age 29-36). We found that birth weight status moderated the association between early motor skills and self-esteem. Stable over three decades, the self-esteem of normal birth weight participants was sensitive to early motor skills such that those with poorer motor functioning manifested lower self-esteem, while those with better motor skills manifested higher self-esteem. Conversely, differences in motor skill development did not affect the self-esteem from adolescence to adulthood in individuals born at extremely low birth weight. Early motor skill development may exert differential effects on self-esteem, depending on whether one is born at term or prematurely.

  5. Maternal and socio-demographic determinants of low birth weight (LBW: A community-based study in a rural block of Assam

    Directory of Open Access Journals (Sweden)

    M Borah

    2016-01-01

    Full Text Available Background and Rationale: Low birth weight (LBW leads to high neonatal and infant deaths. There is also high prevalence of childhood morbidities and mortalities that are consequences of LBW. Objectives: To find out the prevalence of LBW babies among the study population and to find out the effect of certain maternal and socio-demographic characteristics on birth weight. Materials and Methods: This cross-sectional study was carried out in a rural block of Assam. Cluster sampling was done to choose 30 villages and 15 infants were selected randomly from each village to get a sample size of 450. Results: Prevalence of LBW was found to be 21.8%. Percentage of LBW babies was more among the teenage mothers (36% and primipara mothers (27%. Maternal anemia [odds ratio (OR 1.93; confidence interval (CI 1.3-2.9], short interpregnancy interval (OR 3.93; CI 2.16-7.13, and teenage pregnancy (OR 3.93; CI 2.16-6.45 were found to be the independent risk factors associated with LBW of the babies. Discussion: The study findings indicated the high prevalence of LBW babies in rural areas of Assam and illiterate teenage mothers, grand multipara, anemic mothers, and short interpregnancy intervals were the important risk factors for LBW.

  6. Use of a fictitious community-based virtual teaching platform to aid in the teaching of pharmacy practice skills: Student perspectives after initial implementation.

    Science.gov (United States)

    Curley, Louise E; McDonald, Maureen; Aspden, Trudi

    2016-01-01

    Providing patient-centred care requires pharmacy students to learn how to interact effectively and understand individual differences that can influence patients' health. The School of Pharmacy at The University of Auckland, New Zealand (NZ), developed a virtual teaching platform, called NZ Pharmville, which consisted of twenty-one community-based patients who are members of six families; each family had a video vignette associated with it. Bachelor of Pharmacy (BPharm) students, enrolled in the third year pharmacy practice course, were able to view these recorded vignettes as part of their weekly pre-laboratory work for the course. All the clinical cases within the course were based on this community, with the aim of increasing the realism in the practical sessions and increasing patient-centred learning. This study aimed to explore the perspectives of pharmacy students regarding the integration of this virtual community into a third year undergraduate pharmacy practice course. An anonymous, voluntary survey which consisted of twenty-one items, 13 requiring a Likert scale response and 8 requiring free text responses, was distributed to all students who had completed the third year pharmacy practice course. The responses to the questions were collated and analysed. Responses to questions one to thirteen were recorded in Excel, and results were presented as the combination of strongly agree and agree, strongly disagree and disagree and neutral. Responses to free text questions were read multiple times before being coded by two members of the research team into broad themes aligned to the overall aims of the evaluation. Eighty-six (80.4 %) of the eligible students completed the survey and the majority of responses were positive towards the benefits of using the virtual community in the course. Responses indicated that many of the students found the integration of the virtual community to be useful preparation for their practical sessions and the majority of students

  7. Capacity building of skilled birth attendants: a review of pre-service education curricula.

    Science.gov (United States)

    Adegoke, Adetoro A; Mani, Safiyanu; Abubakar, Aisha; van den Broek, Nynke

    2013-07-01

    to assess the level, type and content of pre-service education curricula of health workers providing maternity services against the ICM global standards for Midwifery Education and Essential competencies for midwifery practice. We reviewed the quality and relevance of pre-service education curricula of four cadres of health-care providers of maternity care in Northern Nigeria. we adapted and used the ICM global standards for Midwifery Education and Essential competencies for midwifery practice to design a framework of criteria against which we assessed curricula for pre-service training. We reviewed the pre-service curricula for Nurses, Midwives, Community Health Extension Workers (CHEW) and Junior Community Health Extension Workers (JCHEW) in three states. Criteria against which the curricula were evaluated include: minimum entry requirement, the length of the programme, theory: practice ratio, curriculum model, minimum number of births conducted during training, clinical experience, competencies, maximum number of students allowable and proportion of Maternal, Newborn and Child Health components (MNCH) as part of the total curriculum. four pre-service education programmes were reviewed; the 3 year basic midwifery, 3 year basic nursing, 3 year Community Health Extension Worker (CHEW) and 2 year Junior Community Health Extension Worker (JCHEW) programme. Findings showed that, none of these four training curricula met all the standards. The basic midwifery curriculum most closely met the standards and competencies set out. The nursing curriculum showed a strong focus on foundations of nursing practice, theories of nursing, public health and maternal newborn and child health. This includes well-defined modules on family health which are undertaken from the first year to the third year of the programme. The CHEW and JCHEW curricula are currently inadequate with regard to training health-care workers to be skilled birth attendants. although the midwifery curriculum

  8. BIO - SOCIAL DETERMINANTS OF MOTHERS OF LBW BABIES AND ASSOCIATION OF THEIR HEALTH KNOWLEDGE REGARDING LOW BIRTH WEIGHT BABIES : A COMMUNITY BASED STUDY IN AN URBAN SLUM (DILAWARGANJ NEAR MGM MEDICAL COLLEGE, KISHANGANJ, BIHAR

    Directory of Open Access Journals (Sweden)

    Shubhaditya

    2015-09-01

    Full Text Available BACKGROUND: Low birth weight (LBW is a major public health problem in developing countries including India. The epidemiological observations depicted that infants weighing lesser than 2500 g are approximately 20 times more likely to die than heavier babies, closely associated with the fetal and neonatal mortality and morbid ity. The present study was undertaken with the objectives to find out the relevant socio - demographic and biological determinants of Low Birth Weight babies and t o assess the degree of association between impact of health education and Low birth weight babi es. METHODS: A community based cross sectional study was conducted from May - August 2013 in Dilawarganj, an urban slum, the field practice area of Department of Community Medicine, MGM Medical College, Kishanganj, Bihar. Study population comprised of wome n in 3 rd trimester of pregnancy belonged to DILAWARGANJ urban slum area. 100 mothers of low birth weight and normal birth weight babies at urban slum of Kishanganj (Among them 33 mothers had delivered LBW babies & 67 mothers had delivered normal babies were selected and interviewed through house to house survey with the help of a pre - designed, pre - tested and semi - structured questionnaire. RESULTS: Among the socio - demographic factors that have been considered in the present study, it was observed that 51 .5% mothers belong to age group 20 – 29, 84.8% mothers from Muslim community, 66.67% mothers were illiterate, 69.7% mothers were multipara,75.76% mothers reside in a nuclear family 60.6% mothers were engaged in agricultural fields66.67% belong to lower and poor socio - economic group. It was also observed that 84.85% mothers do not consumes extra meals, 81.82% do not take adequate rest & sleep, 93.9% mothers take less than 100 IFA tablets, 69.7% mothers attend less than 3 ANC, 84.85% mothers practice exclusiv e breast feeding and 78.8% mother give vaccines to their babies. CONCLUSION: The study of LBW baby in

  9. The prevalence and predictive value of weak language skills in children with very low birth weight--a longitudinal study.

    Science.gov (United States)

    Stolt, Suvi; Matomaki, Jaakko; Lind, Annika; Lapinleimu, Helena; Haataja, Leena; Lehtonen, Liisa

    2014-06-01

    Previous findings regarding the prevalence and predictive value of weak language skills in preterm children with very low birth weight (VLBW) are unclear. This study analysed the prevalence of weak language skills, the predictive value of early weak language skills on later weak language skills, and the sensitivity and specificity of cognitive scores for identifying concurrent weak language skills in a longitudinal sample of VLBW children (n = 141) and their full-term controls (n = 146). Data on language skills and cognitive development were gathered at two and five years of age. Weak language skills were defined by the 10th percentile value of the controls. In VLBW children, the prevalence of weak language skills varied between 16% and 18% at 2 years of age (controls: 8 to 10%) and between 20% and 27% at 5 years of age (controls: 10%). Early weak language skills predicted later weak language skills in VLBW children. Cognitive scores were specific, but their sensitivity for identifying concurrent weak language skills was low. The prevalence of weak language skills in VLBW children increased during the follow-up period and was higher than the controls. Language-sensitive methods should be used in the clinical follow-up of VLBW children.

  10. Explaining Disparities in Use of Skilled Birth Attendants in Developing Countries: A Conceptual Framework.

    Science.gov (United States)

    Afulani, Patience A; Moyer, Cheryl

    2016-01-01

    Despite World Health Organization recommendations that all women deliver with a skilled birth attendant (SBA), research continues to demonstrate large disparities in use of SBAs by socioeconomic status (SES). Yet few quantitative studies empirically examine the factors underlying these disparities, due in part to the fact that current models do not provide clear pathways-with measurable mediators-for how distal factors like SES may affect maternal health-seeking behaviors like delivering with SBAs. We propose the Disparities in Skilled Birth Attendance (DiSBA) framework for examining the determinants of use of SBAs. We posit that three proximal factors directly affect use of SBAs: perceived need, perceived accessibility of maternal health services, and perceived quality of care. Distal factors like SES affect use of SBAs indirectly through these proximal factors, and the effects can be measured. We test the assumptions of the DiSBA framework using data from the Ghana Maternal Health Survey. The analytic techniques we use include logistic regression with mediation analysis to examine the intervening effects. We find that our proxies for perceived access, perceived need, and perceived quality of care account for approximately 23% of the difference between women with no education and those with primary school education, and about 55% of the difference between women in the lowest wealth quintile and those in the middle wealth quintiles. This study suggests that proximal factors are worthy of increased attention in terms of measurement, data collection, analysis, programmatic efforts, and policy interventions, as these factors are potentially more amenable to change than the distal factors. The effects of proximal factors are also likely context specific, thus sufficient understanding in different contexts is essential to developing appropriate interventions.

  11. Risk factors for birth defects:A community-based child survey%社区儿童的出生缺陷影响因素探讨

    Institute of Scientific and Technical Information of China (English)

    李敏; 赵丽萍; 商颖; 蔡建华; 周维谨; 车焱

    2011-01-01

    目的:了解以社区为基础的出生缺陷发生水平和有关影响因素,为出生缺陷的预防和孕期保健提供依据.方法:采用多阶段分层整群抽样方法,从我国东、中、西部地区9个中等发达省份中各抽取1个国家人口计生委信息采集抽样县,每个县抽取2个乡镇,再从中各抽取2~4个居委(村),调查其中所有已婚育龄妇女≤9岁子女的出生缺陷发生及相关信息,通过单因素分析和多元logistic回归分析,探讨出生缺陷的影响因素.结果:调查对象共3958例,出生缺陷发生率为1.80%.单因素卡方检验发现母亲产龄、文化程度、流产史、孕期微量营养素补充、产检机构与出生缺陷发生有关(P <0.05).多元logistic回归分析显示,产龄16~20岁(OR=2.53,95 % CI:1.25~5.10)、有人工流产史(OR=3.32,95% CI:1.69~6.51)、吸烟(OR=3.34,95 % CI:1.04~10.75)、孕期未补充微量元素(OR=1.84,95%CI:1.07~3.16)、在乡镇及以下机构产前检查(OR=1.70,95% CI:1.06~2.74)的母亲生育出生缺陷儿的危险较高.结论:出生缺陷预防干预应重点关注既往有人工流产史、低龄、吸烟孕妇对象,重视基层产前检查机构服务能力建设,提供优质孕期监测与营养保健咨询服务.%Objective; To explore the prevalence and risk factors for birth defects ( BD) among children in 9 provinces of China. Methods; By using stratified, random cluster sampling methods, 17 townships and 36 rural villages and urban neighbourhood were sampled from 9 provinces of China. All married women aged between 20 - 49 years old were investigated and a questionnaire survey on birth defects of their children under 9 year - old was conducted. Chi - square test and multivariate logistic regression analysis were used to evaluate the association between BD and maternal risk factors. Results: There were 3 958 respondents, and the prevalence of BD was 1.80%. Results of chi - square tests indicated that maternal age

  12. Impact on postpartum hemorrhage of prophylactic administration of oxytocin 10 IU via UnijectTM by peripheral health care providers at home births: design of a community-based cluster-randomized trial

    Directory of Open Access Journals (Sweden)

    Stanton Cynthia K

    2012-06-01

    Full Text Available Abstract Background Hemorrhage is the leading direct cause of maternal death globally. While oxytocin is the drug of choice for postpartum hemorrhage prevention, its use has generally been limited to health facilities. This trial assesses the effectiveness, safety, and feasibility of expanding the use of prophylactic intramuscular oxytocin to peripheral health care providers at home births in four predominantly rural districts in central Ghana. Methods This study is designed as a community-based cluster-randomized trial in which Community Health Officers are randomized to provide (or not provide an injection of oxytocin 10 IU via the UnijectTM injection system within one minute of delivery of the baby to women who request their presence at home at the onset of labor. The primary aim is to determine if administration of prophylactic oxytocin via Uniject™ by this cadre will reduce the risk of postpartum hemorrhage by 50 % relative to deliveries which do not receive the prophylactic intervention. Postpartum hemorrhage is examined under three sequential definitions: 1 blood loss ≥500 ml (BL; 2 treatment for bleeding (TX and/or BL; 3 hospital referral for bleeding and/or TX and/or BL. Secondary outcomes address safety and feasibility of the intervention and include adverse maternal and fetal outcomes and logistical concerns regarding assistance at home births and the storage and handling of oxytocin, respectively. Discussion Results from this trial will build evidence for the effectiveness of expanding the delivery of this established prophylactic intervention to peripheral settings. Complementary data on safety and logistical issues related to this intervention will assist policymakers in low-income countries in selecting both the best uterotonic and service delivery strategy for postpartum hemorrhage prevention. Results of this trial are expected in mid-2013. The trial is registered at ClinicalTrials.gov: NCT01108289.

  13. Impact on postpartum hemorrhage of prophylactic administration of oxytocin 10 IU via UnijectTM by peripheral health care providers at home births: design of a community-based cluster-randomized trial

    Science.gov (United States)

    2012-01-01

    Background Hemorrhage is the leading direct cause of maternal death globally. While oxytocin is the drug of choice for postpartum hemorrhage prevention, its use has generally been limited to health facilities. This trial assesses the effectiveness, safety, and feasibility of expanding the use of prophylactic intramuscular oxytocin to peripheral health care providers at home births in four predominantly rural districts in central Ghana. Methods This study is designed as a community-based cluster-randomized trial in which Community Health Officers are randomized to provide (or not provide) an injection of oxytocin 10 IU via the UnijectTM injection system within one minute of delivery of the baby to women who request their presence at home at the onset of labor. The primary aim is to determine if administration of prophylactic oxytocin via Uniject™ by this cadre will reduce the risk of postpartum hemorrhage by 50 % relative to deliveries which do not receive the prophylactic intervention. Postpartum hemorrhage is examined under three sequential definitions: 1) blood loss ≥500 ml (BL); 2) treatment for bleeding (TX) and/or BL; 3) hospital referral for bleeding and/or TX and/or BL. Secondary outcomes address safety and feasibility of the intervention and include adverse maternal and fetal outcomes and logistical concerns regarding assistance at home births and the storage and handling of oxytocin, respectively. Discussion Results from this trial will build evidence for the effectiveness of expanding the delivery of this established prophylactic intervention to peripheral settings. Complementary data on safety and logistical issues related to this intervention will assist policymakers in low-income countries in selecting both the best uterotonic and service delivery strategy for postpartum hemorrhage prevention. Results of this trial are expected in mid-2013. The trial is registered at ClinicalTrials.gov: NCT01108289. PMID:22676921

  14. Does the Janani Suraksha Yojana cash transfer programme to promote facility births in India ensure skilled birth attendance? A qualitative study of intrapartum care in Madhya Pradesh

    Directory of Open Access Journals (Sweden)

    Sarika Chaturvedi

    2015-07-01

    Full Text Available Background: Access to facility delivery in India has significantly increased with the Janani Suraksha Yojana (JSY cash transfer programme to promote facility births. However, a decline in maternal mortality has only followed secular trends as seen from the beginning of the decade well before the programme began. We, therefore, examined the quality of intrapartum care provided in facilities under the JSY programme to study whether it ensures skilled attendance at birth. Design: 1 Non-participant observations (n=18 of intrapartum care during vaginal deliveries at a representative sample of 11 facilities in Madhya Pradesh to document what happens during intrapartum care. 2 Interviews (n=10 with providers to explore reasons for this care. Thematic framework analysis was used. Results: Three themes emerged from the data: 1 delivery environment is chaotic: delivery rooms were not conducive to safe, women-friendly care provision, and coordination between providers was poor. 2 Staff do not provide skilled care routinely: this emerged from observations that monitoring was limited to assessment of cervical dilatation, lack of readiness to provide key elements of care, and the execution of harmful/unnecessary practices coupled with poor techniques. 3 Dominant staff, passive recipients: staff sometimes threatened, abused, or ignored women during delivery; women were passive and accepted dominance and disrespect. Attendants served as ‘go-betweens’ patients and providers. The interviews with providers revealed their awareness of the compromised quality of care, but they were constrained by structural problems. Positive practices were also observed, including companionship during childbirth and women mobilising in the early stages of labour. Conclusions: Our observational study did not suggest an adequate level of skilled birth attendance (SBA. The findings reveal insufficiencies in the health system and organisational structures to provide an

  15. Does the Janani Suraksha Yojana cash transfer programme to promote facility births in India ensure skilled birth attendance? A qualitative study of intrapartum care in Madhya Pradesh.

    Science.gov (United States)

    Chaturvedi, Sarika; De Costa, Ayesha; Raven, Joanna

    2015-01-01

    Access to facility delivery in India has significantly increased with the Janani Suraksha Yojana (JSY) cash transfer programme to promote facility births. However, a decline in maternal mortality has only followed secular trends as seen from the beginning of the decade well before the programme began. We, therefore, examined the quality of intrapartum care provided in facilities under the JSY programme to study whether it ensures skilled attendance at birth. 1) Non-participant observations (n=18) of intrapartum care during vaginal deliveries at a representative sample of 11 facilities in Madhya Pradesh to document what happens during intrapartum care. 2) Interviews (n=10) with providers to explore reasons for this care. Thematic framework analysis was used. Three themes emerged from the data: 1) delivery environment is chaotic: delivery rooms were not conducive to safe, women-friendly care provision, and coordination between providers was poor. 2) Staff do not provide skilled care routinely: this emerged from observations that monitoring was limited to assessment of cervical dilatation, lack of readiness to provide key elements of care, and the execution of harmful/unnecessary practices coupled with poor techniques. 3) Dominant staff, passive recipients: staff sometimes threatened, abused, or ignored women during delivery; women were passive and accepted dominance and disrespect. Attendants served as 'go-betweens' patients and providers. The interviews with providers revealed their awareness of the compromised quality of care, but they were constrained by structural problems. Positive practices were also observed, including companionship during childbirth and women mobilising in the early stages of labour. Our observational study did not suggest an adequate level of skilled birth attendance (SBA). The findings reveal insufficiencies in the health system and organisational structures to provide an 'enabling environment' for SBA. We highlight the need to ensure

  16. Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study

    Directory of Open Access Journals (Sweden)

    Sharad Onta

    2014-08-01

    Full Text Available Background: Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care. Design: We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers. Results: Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs, distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities. Conclusions: Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps.

  17. Awareness of critical danger signs of pregnancy and delivery, preparations for delivery, and utilization of skilled birth attendants in Nigeria.

    Science.gov (United States)

    Doctor, Henry V; Findley, Sally E; Cometto, Giorgio; Afenyadu, Godwin Y

    2013-02-01

    Maternal mortality in northern Nigeria is among the highest in the world. To understand better the pathways through which the socio-demographic environment affects awareness of obstetric danger signs (i.e., potential problems associated with pregnancy), preparations for delivery, and skilled birth attendance, we conducted a survey of 5,083 women with recent pregnancies in three northern Nigerian states. Only 25% attended antenatal care (ANC), and 91% of all births took place at home. Less than one-third knew three or more danger signs of pregnancy or labor and delivery. Higher socioeconomic status was associated with knowledge of danger signs, but not with knowledge of life-threatening, critical danger signs. Antenatal care visits did not increase knowledge of critical danger signs, but they were associated with skilled birth attendance. Knowledge of critical pregnancy danger signs also was associated with skilled birth attendance. Improving the quality and coverage of ANC will ensure greater awareness of the critical danger signs. Future research is needed to identify creative and innovative ways to strengthen strategies for educating pregnant women about danger signs and in facilitating uptake of delivery services.

  18. Women’s Health Decision-Making Autonomy and Skilled Birth Attendance in Ghana

    Directory of Open Access Journals (Sweden)

    Edward Kwabena Ameyaw

    2016-01-01

    Full Text Available Delivering in health facility under the supervision of skilled birth attendant is an important way of mitigating impacts of delivery complications. Empirical evidence suggests that decision-making autonomy is aligned with holistic wellbeing especially in the aspect of maternal and child health. The objective of this paper was to examine the relationship between women’s health decision-making autonomy and place of delivery in Ghana. We extracted data from the 2014 Ghana Demographic and Health Survey. Descriptive and logistic regression techniques were applied. The results indicated that women with health decision-making autonomy have higher tendency of health facility delivery as compared to those who are not autonomous [OR = 1.27, CI = 1.09–1.48]. However, those who have final say on household large purchases [OR = 0.71, CI = 0.59–0.84] and those having final say on visits [OR = 0.86, CI = 0.73–1.01] were less probable to deliver in health facility than those without such decision-making autonomy. Consistent with existing evidence, wealthier, urban, and highly educated women had higher inclination of health facility delivery. This study has stressed the need for interventions aimed at enhancing health facility delivery to target women without health decision-making autonomy and women with low education and wealth status, as this can play essential role in enhancing health facility delivery.

  19. Women's Health Decision-Making Autonomy and Skilled Birth Attendance in Ghana.

    Science.gov (United States)

    Ameyaw, Edward Kwabena; Tanle, Augustine; Kissah-Korsah, Kwaku; Amo-Adjei, Joshua

    2016-01-01

    Delivering in health facility under the supervision of skilled birth attendant is an important way of mitigating impacts of delivery complications. Empirical evidence suggests that decision-making autonomy is aligned with holistic wellbeing especially in the aspect of maternal and child health. The objective of this paper was to examine the relationship between women's health decision-making autonomy and place of delivery in Ghana. We extracted data from the 2014 Ghana Demographic and Health Survey. Descriptive and logistic regression techniques were applied. The results indicated that women with health decision-making autonomy have higher tendency of health facility delivery as compared to those who are not autonomous [OR = 1.27, CI = 1.09-1.48]. However, those who have final say on household large purchases [OR = 0.71, CI = 0.59-0.84] and those having final say on visits [OR = 0.86, CI = 0.73-1.01] were less probable to deliver in health facility than those without such decision-making autonomy. Consistent with existing evidence, wealthier, urban, and highly educated women had higher inclination of health facility delivery. This study has stressed the need for interventions aimed at enhancing health facility delivery to target women without health decision-making autonomy and women with low education and wealth status, as this can play essential role in enhancing health facility delivery.

  20. Rate of Utilization of Skilled Birth Attendant and the Influencing Factors in an Urban Myanmar Population.

    Science.gov (United States)

    Chamroonsawasdi, Kanittha; Soe, Malar; Charupoonphol, Phitaya; Srisorrachatr, Suwat

    2015-07-01

    A survey study aimed at identifying rates and predictive factors on utilization of skilled birth attendant (SBA) among pregnant women. A stratified random sampling technique was used to select 200 Myanmar women aged 18 to 49 years in Kalay Township. Data were collected by interview questionnaire from March 1 to 15, 2012, and data were analyzed by frequency, percentage, mean and standard deviation, χ(2) test, and multiple logistic regression analysis. The utilization rate of SBA was 74%. Factors significantly predicting utilization of SBA (P utilized SBA 2.7 times more than those who had a poor level of knowledge (odds ratio = 2.705, 95% confidence interval = 1.31-5.57). The women who had a positive attitude toward SBA utilized SBA 7.7 times more than those who had a negative attitude (odds ratio = 7.708, 95% confidence interval = 3.71-15.98). The women who had high accessibility to MCH services utilized SBA 1.4 times more than those who had low accessibility (odds ratio = 1.477, 95% confidence interval = 1.05-2.21). These factors were able to correctly predict utilization of SBA at 74.9%. MCH knowledge and information on utilization of SBA should be strengthened during every antenatal care visit to enhance positive attitude on utilization of SBA and to increase accessibility to MCH services by providing community antenatal care or home visits. © 2015 APJPH.

  1. Social attribution skills of children born preterm at very low birth weight.

    Science.gov (United States)

    Williamson, Kathryn E; Jakobson, Lorna S

    2014-11-01

    Children born prematurely at very low birth weight (<1500 g) are at increased risk for impairments affecting social functioning, including autism spectrum disorders (e.g., Johnson et al., 2010). In the current study, we used the Happé-Frith animated triangles task (Abell, Happé, & Frith, 2000) to study social attribution skills in this population. In this task, typical viewers attribute intentionality and mental states to shapes, based on characteristics of their movements. Participants included 34 preterm children and 36 full-term controls, aged 8-11 years. Groups were comparable in terms of age at test, gender, handedness, and socioeconomic status; they also performed similarly on tests of selective attention/processing speed and verbal intelligence. Relative to full-term peers, preterm children's descriptions of the animations were less appropriate overall; they also overattributed intentionality/mental states to randomly moving shapes and underattributed intentionality/mental states to shapes that seemed to be interacting socially. Impairments in the ability to infer the putative mental states of triangles from movement cues alone were most evident in children displaying more "autistic-like" traits, and this may reflect atypical development of and/or functioning in, or atypical connections between, parts of the social brain.

  2. Testing the efficacy of culturally adapted coping skills training for Chinese American immigrants with type 2 diabetes using community-based participatory research.

    Science.gov (United States)

    Chesla, Catherine A; Chun, Kevin M; Kwan, Christine M L; Mullan, Joseph T; Kwong, Yulanda; Hsu, Lydia; Huang, Peggy; Strycker, Lisa A; Shum, Tina; To, Diana; Kao, Rudy; Waters, Catherine M

    2013-08-01

    Chinese Americans demonstrate greater prevalence of diabetes than non-Hispanic whites and find standard diabetes care disregards their cultural health beliefs. Academic researchers and Chinatown agencies collaborated to culturally adapt and test an efficacious cognitive-behavioral intervention using community-based participatory research. Using a delayed-treatment repeated-measures design, 145 adult Chinese immigrants with Type 2 diabetes completed treatment. Immediate benefits of treatment were evident in the improvement (p diabetes self-efficacy, diabetes knowledge, bicultural efficacy, family emotional and instrumental support, diabetes quality of life, and diabetes distress. Prolonged benefits were evident in all changed variables 2 months post-intervention. The CBPR approach enabled the development of a culturally acceptable, efficacious behavioral intervention, and provides a model for working with communities that demonstrate health disparities.

  3. High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention

    Directory of Open Access Journals (Sweden)

    Cousens Simon

    2010-03-01

    Full Text Available Abstract Background In Tanzania, more than 90% of all pregnant women attend antenatal care at least once and approximately 62% four times or more, yet less than five in ten receive skilled delivery care at available health units. We conducted a qualitative study in Ngorongoro district, Northern Tanzania, in order to gain an understanding of the health systems and socio-cultural factors underlying this divergent pattern of high use of antenatal services and low use of skilled delivery care. Specifically, the study examined beliefs and behaviors related to antenatal, labor, delivery and postnatal care among the Maasai and Watemi ethnic groups. The perspectives of health care providers and traditional birth attendants on childbirth and the factors determining where women deliver were also investigated. Methods Twelve key informant interviews and fifteen focus group discussions were held with Maasai and Watemi women, traditional birth attendants, health care providers, and community members. Principles of the grounded theory approach were used to elicit and assess the various perspectives of each group of participants interviewed. Results The Maasai and Watemi women's preferences for a home birth and lack of planning for delivery are reinforced by the failure of health care providers to consistently communicate the importance of skilled delivery and immediate post-partum care for all women during routine antenatal visits. Husbands typically serve as gatekeepers of women's reproductive health in the two groups - including decisions about where they will deliver- yet they are rarely encouraged to attend antenatal sessions. While husbands are encouraged to participate in programs to prevent maternal-to-child transmission of HIV, messages about the importance of skilled delivery care for all women are not given emphasis. Conclusions Increasing coverage of skilled delivery care and achieving the full implementation of Tanzania's Focused Antenatal Care

  4. Community Based Distribution

    African Journals Online (AJOL)

    Community Based Distribution (CBD) is a relatively new concept. It is a service that reaches ... neration; Resupply systems; Pricing of contraceptives; Mix of services ... tion on how best to design and implement the project and the community in ...

  5. Increasing access to safe abortion services through auxiliary nurse midwives trained as skilled birth attendants.

    Science.gov (United States)

    K C, N P; Basnett, I; Sharma, S K; Bhusal, C L; Parajuli, R R; Andersen, K L

    2011-01-01

    The use of medical abortion methods was approved by Department of Health Services in 2009 and introduced in hospitals and a few primary health centres (PHCs). Access would increase if services were available at health post level and provided by auxiliary nurse midwives trained as skilled birth attendants. Evidence from South Africa, Bangladesh, Nepal and Vietnam show that mid-level health workers can provide medical abortion safely. To determine the best way to implement the new strategies of medical abortion into the existing health system of Nepal; and to facilitate its full-scale implementation, monitoring and evaluation. An implementation research involving a baseline study, implementation phase and end line study was done in ten districts covering five development regions from July 2010 to June 2011. Both qualitative and quantitative methods were used. Of 1,799 medical abortion clients who received service, 46% were disadvantaged Janjati, 14% were Dalit, 42% were upper caste groups and rest were advantaged Janjati (7%), Muslim (1%) and others. 14% were referred by female community health volunteers and 56% were referred by others. Complication rate of 0.3% was well below acceptable levels. Condom use increased from 8% to 28% by the end of study. Use of Pills, Depo, intra uterine devices and implants also increased, but use of long acting family planning methods was negligible. This model should be replicated nationwide at health posts and sub-health posts where auxiliary nurse midwives are available 24 hours/day. Focus should be given first to those areas where access is difficult, time consuming and costly.

  6. Impact of a Community-Based Programme for Motor Development on Gross Motor Skills and Cognitive Function in Preschool Children from Disadvantaged Settings

    Science.gov (United States)

    Draper, Catherine E.; Achmat, Masturah; Forbes, Jared; Lambert, Estelle V.

    2012-01-01

    The aims of the studies were to assess the impact of the Little Champs programme for motor development on (1) the gross motor skills, and (2) cognitive function of children in the programme. In study 1, 118 children from one Early Childhood Development Centre (ECDC) were tested using the Test of Gross Motor Development-2, and in study 2, 83…

  7. A geospatial analysis of the impacts of maternity care fee payment policies on the uptake of skilled birth care in Ghana

    OpenAIRE

    2016-01-01

    Background Many low and middle income countries have initiated maternity fee exemption and removal policies to promote use of skilled maternity care. After two and a half decades of these policies, uptake of skilled birth care remains low and inequalities continue to exist in many low and middle income countries. This study uses 2 decades of birth histories data to examine four maternity fee paying policies enacted in Ghana over the past 3 decades and their geospatial impacts on uptake of ski...

  8. Massage Interventions and Developmental Skills in Infants Born with Low Birth Weight

    Science.gov (United States)

    Kelmanson, I. A.; Adulas, E. I.

    2009-01-01

    This study aimed at evaluating possible effects of massage interventions on developmental progress in the infants born with low birth weight (LBW). Forty infants (17 boys, 23 girls) who were born in St. Petersburg in 2000 through 2002 and met a conventional definition of LBW (less than 2500 g at birth) entered the study. Of these, 36 (17 boys, 19…

  9. Massage Interventions and Developmental Skills in Infants Born with Low Birth Weight

    Science.gov (United States)

    Kelmanson, I. A.; Adulas, E. I.

    2009-01-01

    This study aimed at evaluating possible effects of massage interventions on developmental progress in the infants born with low birth weight (LBW). Forty infants (17 boys, 23 girls) who were born in St. Petersburg in 2000 through 2002 and met a conventional definition of LBW (less than 2500 g at birth) entered the study. Of these, 36 (17 boys, 19…

  10. Labor and birth care by nurse with midwifery skills in Brazil.

    Science.gov (United States)

    Gama, Silvana Granado Nogueira da; Viellas, Elaine Fernandes; Torres, Jacqueline Alves; Bastos, Maria Helena; Brüggemann, Odaléa Maria; Theme Filha, Mariza Miranda; Schilithz, Arthur Orlando Correa; Leal, Maria do Carmo

    2016-10-17

    The participation of nurses and midwives in vaginal birth care is limited in Brazil, and there are no national data regarding their involvement. The goal was to describe the participation of nurses and nurse-midwives in childbirth care in Brazil in the years 2011 and 2012, and to analyze the association between hospitals with nurses and nurse-midwives in labor and birth care and the use of good practices, and their influence in the reduction of unnecessary interventions, including cesarean sections. Birth in Brazil is a national, population-based study consisting of 23,894 postpartum women, carried out in the period between February 2011 and October 2012, in 266 healthcare settings. The study included all vaginal births involving physicians or nurses/nurse-midwives. A logistic regression model was used to examine the association between the implementation of good practices and suitable interventions during labor and birth, and whether care was a physician or a nurse/nurse-midwife led care. We developed another model to assess the association between the use of obstetric interventions during labor and birth to the personnel responsible for the care of the patient, comparing hospitals with decisions revolving exclusively around a physician to those that also included nurses/nurse-midwives as responsible for vaginal births. 16.2 % of vaginal births were assisted by a nurse/nurse-midwife. Good practices were significantly more frequent in those births assisted by nurses/nurse-midwives (ad lib. diet, mobility during labor, non-pharmacological means of pain relief, and use of a partograph), while some interventions were less frequently used (anesthesia, lithotomy position, uterine fundal pressure and episiotomy). In maternity wards that included a nurse/nurse-midwife in labour and birth care, the incidence of cesarean section was lower. The results of this study illustrate the potential benefit of collaborative work between physicians and nurses/nurse-midwives in labor

  11. Family Connections: Promoting Early Literacy Skills--Ages Birth to 5

    Science.gov (United States)

    Huisman, Sarah

    2012-01-01

    Reading, writing, and communicating, also known as literacy, are important cognitive skills to teach within society. Early literacy is knowledge about reading and writing before actually being able to read and write and is the foundation to future reading and writing skills (Ghoting & Martin-Diaz, 2006). The role of families in developing early…

  12. Preschool motor skills following physical and occupational therapy services among non-disabled very low birth weight children.

    Science.gov (United States)

    Watkins, Stephanie; Jonsson-Funk, Michele; Brookhart, M Alan; Rosenberg, Steven A; O'Shea, T Michael; Daniels, Julie

    2014-05-01

    Children born very low birth weight (VLBW) are at an increased risk of delayed development of motor skills. Physical and occupational therapy services may reduce this risk. Among VLBW children, we evaluated whether receipt of physical or occupational therapy services between 9 months and 2 years of age is associated with improved preschool age motor ability. Using data from the Early Childhood Longitudinal Study Birth Cohort we estimated the association between receipt of therapy and the following preschool motor milestones: skipping eight consecutive steps, hopping five times, standing on one leg for 10 seconds, walking backwards six steps on a line, and jumping distance. We used propensity score methods to adjust for differences in baseline characteristics between children who did and did not receive physical or occupational therapy, since children receiving therapy may be at higher risk of impairment. We applied propensity score weights and modeled the estimated effect of therapy on the distance that the child jumped using linear regression. We modeled all other end points using logistic regression. Treated VLBW children were 1.70 times as likely to skip eight steps (RR 1.70, 95 % CI 0.84, 3.44) compared to the untreated group and 30 % more likely to walk six steps backwards (RR 1.30, 95 % CI 0.63, 2.71), although these differences were not statistically significant. We found little effect of therapy on other endpoints. Providing therapy to VLBW children during early childhood may improve select preschool motor skills involving complex motor planning.

  13. Utilisation of Non-Skilled Birth Attendants in Northern Nigeria: A ...

    African Journals Online (AJOL)

    HVD

    *For Correspondence: Henry V. Doctor. E-mail: ... Among women with a last live birth delivered anytime within the five years prior to ... Yobe State were 42% more likely to be assisted by NSBA compared with residents of Katsina State. Key.

  14. Evaluating Birth Preparedness and Pregnancy Complications Readiness Knowledge and Skills of Accredited Social Health Activists in India

    Directory of Open Access Journals (Sweden)

    Smitha Kochukuttan, BDS, MPH

    2013-07-01

    Full Text Available Background: The National Rural Health Mission (NRHM in India relies on Accredited Social Health Activists (ASHAs to act as a link between pregnant women and health facilities. All ASHAs are required to have a birth preparedness plan and be aware of danger signs of complications to initiate appropriate and timely referral to obstetric care. Objectives: To examine the extent to which Accredited Social Health Activists (ASHAs are equipped with necessary knowledge and skills and the adequacy of support they get from supervisors to carry out their assigned tasks in a rural district in Karnataka, (South India. Methods: A cross-sectional descriptive study was carried out among 225 ASHAs between June -July 2011. Quantitative and qualitative data were collected using pre-tested semi-structured interview schedule. The data were analyzed using SPSS version 17. Chi-square test was used to determine associations between categorical variables. Results: The response rate was 207(92%. In terms of knowledge of all key danger signs (Complication Readiness, 2(1%, 10(4.8%, and 15(7.2% ASHAs were aware of key danger signs for labor and child birth, postpartum period and pregnancy period, respectively. Knowledge of key danger signs was associated with repeated, recent and practical training (p <0.05. A majority (71% scored 4-7 of the maximum score out of 8 for knowledge regarding Birth Preparedness. Conclusion and Public health implications: ASHAs in rural Karnataka, India, are poorly equipped to identify obstetric complications and to help expectant mothers prepare a birth preparedness plan. There is critical need for the implementation of appropriate training and follow-up supervision of ASHAs within a supportive, functioning and responsive health care system.

  15. 社会技能训练对社区精神分裂症患者康复的影响%Influence of social skill training on community-based rehabilitation of patients with schizophrenia

    Institute of Scientific and Technical Information of China (English)

    陈涛; 阮召锐; 陈明钟; 陈鸿琴; 陈元生

    2014-01-01

    目的:探讨社会技能训练对社区精神分裂症患者的影响。方法将96例社区精神分裂症患者随机分成研究组和对照组各48例。对研究组进行药物自我管理和症状自我监控技能训练共16周,对照组开展常规的精神卫生康复服务(物理治疗及工娱治疗)16周,然后随访观察12个月。采用社会功能量表PSP、阳性阴性症状量表PANSS对研究对象进行评估。结果研究组PANSS(45.92±15.03)、PSP(70.31±8.65)明显优于对照组PANSS(53.32±16.21)、PSP(61.9±10.58),差异具有统计学意义(P<0.05)。研究组复发率14.6%低于对照组25.0%,差异有统计学意义。研究组再就业率12.5%高于对照组再就业率8.3%,差异无统计学意义(P>0.05)。结论社会独立技能训练有利于精神分裂症患者社区康复,再就业面临无职业康复机构。%Objective To investigate the influence of social skill training on the community-based rehabilitation of patients with schizophrenia. Methods Ninety-six community patients with schizophrenia were randomly divided into the study group and the control group, with 48 patients in each group. The study group received skill training on drug self-management and symptom self-monitoring for a total of 16 weeks. The control group received conventional mental health rehabilitation services(physical therapy and occupational and recreational therapy) for 16 weeks. Then the patients were followed up for 12 months. The personal and social performance scale(PSP) and the positive and negative syndrome scale(PANSS) were used to evaluate the study subjects. Results The study group had significantly better PANSS (45.92 ± 15.03) and PSP (70.31 ± 8.65) than the control group PANSS (53.32 ± 16.21) and PSP (61.9 ± 10.58), with significant differences(P0.05). Conclusion Social independent skill training is conducive to the community-based rehabilitation of patients with schizophrenia

  16. Shifting norms: pregnant women's perspectives on skilled birth attendance and facility-based delivery in rural Ghana.

    Science.gov (United States)

    Crissman, Halley P; Engmann, Cyril E; Adanu, Richard M; Nimako, Doris; Crespo, Keesha; Moyer, Cheryl A

    2013-03-01

    Skilled birth attendance (SBA) and healthcare facility (HCF) delivery are effective means of reducing maternal mortality. However, their uptake remains low in many low-income countries. The present study utilized semi-structured interviews with 85 pregnant women attending an antenatal clinic in Akwatia, Ghana (May-July 2010) to better understand the barriers to SBA and HCF delivery through the underrepresented perspective of pregnant women. Interview transcripts were analyzed using grounded theory methodology. Participants described community support for and uptake of HCF delivery as increasing and becoming normalized, but barriers remain: (1) maltreatment by midwives; (2) cost associated with HCF delivery despite waived facility fees; (3) the need for a support person for HCF delivery; (4) difficulties in transportation; and (5) precipitous labor. Given the importance of community in Ghanaian health care decision-making, increasing community support for HCF delivery suggests progress toward increasing uptake of SBA and HCF delivery, however important actionable barriers remain.

  17. Health facility and skilled birth deliveries among poor women with Jamkesmas health insurance in Indonesia: a mixed-methods study.

    Science.gov (United States)

    Brooks, Mohamad I; Thabrany, Hasbullah; Fox, Matthew P; Wirtz, Veronika J; Feeley, Frank G; Sabin, Lora L

    2017-02-02

    The growing momentum for quality and affordable health care for all has given rise to the recent global universal health coverage (UHC) movement. As part of Indonesia's strategy to achieve the goal of UHC, large investments have been made to increase health access for the poor, resulting in the implementation of various health insurance schemes targeted towards the poor and near-poor, including the Jamkesmas program. In the backdrop of Indonesia's aspiration to reach UHC is the high rate of maternal mortality that disproportionally affects poor women. The objective of this study was to evaluate the association of health facility and skilled birth deliveries among poor women with and without Jamkesmas and explore perceived barriers to health insurance membership and maternal health service utilization. We used a mixed-methods design. Utilizing data from the 2012 Indonesian Demographic and Health Survey (n = 45,607), secondary analysis using propensity score matching was performed on key outcomes of interest: health facility delivery (HFD) and skilled birth delivery (SBD). In-depth interviews (n = 51) were conducted in the provinces of Jakarta and Banten among poor women, midwives, and government representatives. Thematic framework analysis was performed on qualitative data to explore perceived barriers. In 2012, 63.0% of women did not have health insurance; 19.1% had Jamkesmas. Poor women with Jamkesmas were 19% (OR = 1.19 [1.03-1.37]) more likely to have HFD and 17% (OR = 1.17 [1.01-1.35]) more likely to have SBD compared to poor women without insurance. Qualitative interviews highlighted key issues, including: lack of proper documentation for health insurance registration; the preference of pregnant women to deliver in their parents' village; the use of traditional birth attendants; distance to health facilities; shortage of qualified health providers; overcrowded health facilities; and lack of health facility accreditation. Poor women with

  18. Skilled birth attendants in Tanzania: a descriptive study of cadres and emergency obstetric care signal functions performed.

    Science.gov (United States)

    Ueno, Etsuko; Adegoke, Adetoro A; Masenga, Gileard; Fimbo, Janeth; Msuya, Sia E

    2015-01-01

    Although most developing countries monitor the proportion of births attended by skilled birth attendants (SBA), they lack information on the availability and performance of emergency obstetric care (EmOC) signal functions by different cadres of health care providers (HCPs). The World Health Organisation signal functions are set of key interventions that targets direct obstetric causes of maternal deaths. Seven signal functions are required for health facilities providing basic EmOC and nine for facilities providing comprehensive EmOC. Our objectives were to describe cadres of HCPs who are considered SBAs in Tanzania, the EmOC signal functions they perform and challenges associated with performance of EmOC signal functions. We conducted a cross-sectional study of HCPs offering maternity care services at eight health facilities in Moshi Urban District in northern Tanzania. A questionnaire and health facility assessment forms were used to collect information from participants and health facilities. A total of 199 HCPs working at eight health facilities in Moshi Urban District met the inclusion criteria. Out of 199, 158 participated, giving a response rate of 79.4 %. Ten cadres of HCPs were identified as conducting deliveries regardless of the level of health facilities. Most of the participants (81 %) considered themselves SBAs, although some were not considered SBAs by the Ministry of Health and Social Welfare (MOHSW). Only two out of the eight facilities provided all of the required EmOC signal functions. While Assistant Medical Officers are expected to perform all the signal functions, only 38 % and 13 % had performed vacuum extraction or caesarean sections respectively. Very few registered and enrolled nurse-midwives had performed removal of retained products (22 %) or assisted vaginal delivery (24 and 11 %). Inadequate equipment and supplies, and lack of knowledge and skills in performing EmOC were two main challenges identified by health care providers in all

  19. Training traditional birth attendants to use misoprostol and an absorbent delivery mat in home births.

    Science.gov (United States)

    Prata, Ndola; Quaiyum, Md Abdul; Passano, Paige; Bell, Suzanne; Bohl, Daniel D; Hossain, Shahed; Azmi, Ashrafi Jahan; Begum, Mohsina

    2012-12-01

    A 50-fold disparity in maternal mortality exists between high- and low-income countries, and in most contexts, the single most common cause of maternal death is postpartum hemorrhage (PPH). In Bangladesh, as in many other low-income countries, the majority of deliveries are conducted at home by traditional birth attendants (TBAs) or family members. In the absence of skilled birth attendants, training TBAs in the use of misoprostol and an absorbent delivery mat to measure postpartum blood loss may strengthen the ability of TBAs to manage PPH. These complementary interventions were tested in operations research among 77,337 home births in rural Bangladesh. The purpose of this study was to evaluate TBAs' knowledge acquisition, knowledge retention, and changes in attitudes and practices related to PPH management in home births after undergoing training on the use of misoprostol and the blood collection delivery mat. We conclude that the training was highly effective and that the two interventions were safely and correctly used by TBAs at home births. Data on TBA practices indicate adherence to protocol, and 18 months after the interventions were implemented, TBA knowledge retention remained high. This program strengthens the case for community-based use of misoprostol and warrants consideration of this intervention as a potential model for scale-up in settings where complete coverage of skilled birth attendants (SBAs) remains a distant goal.

  20. Reading, Mathematics and Fine Motor Skills at 5 Years of Age in US Children who were Extremely Premature at Birth.

    Science.gov (United States)

    Lee, Miryoung; Pascoe, John M; McNicholas, Caroline I

    2017-01-01

    Objectives The prevalence of extreme prematurity at birth has increased, but little research has examined its impact on developmental outcomes in large representative samples within the United States. This study examined the association of extreme prematurity with kindergarteners' reading skills, mathematics skills and fine motor skills. Methods The early childhood longitudinal study-birth cohort, a representative sample of the US children born in 2001 was analyzed for this study. Early reading and mathematics skills and fine motor skills were compared among 200 extremely premature children (EPC) (gestational age sampling weights, children's age, race, sex, and general health status, and parental marital status and education among singleton children. Results At age 5 years, EPC were 2.6(95 % CI 1.7-3.8) times more likely to fail build a gate and were 3.1(95 % CI 1.6-5.8) times more likely to fail all four drawing tasks compared to TC (p values gate, 1.3[95 % CI 1.0-1.7]; failed to draw all four shapes, 1.1[95 % CI 0.8-1.6]) was not significantly different from TC. Mean early reading scale score (36.8[SE:1.3]) of EPC was 4.0 points lower than TC (p value sample of infants, the biological risk of extreme prematurity persists after adjusting for other factors related to development.

  1. Are community midwives addressing the inequities in access to skilled birth attendance in Punjab, Pakistan? Gender, class and social exclusion.

    Science.gov (United States)

    Mumtaz, Zubia; O'Brien, Beverley; Bhatti, Afshan; Jhangri, Gian S

    2012-09-19

    Pakistan is one of the six countries estimated to contribute to over half of all maternal deaths worldwide. To address its high maternal mortality rate, in particular the inequities in access to maternal health care services, the government of Pakistan created a new cadre of community-based midwives (CMW). A key expectation is that the CMWs will improve access to skilled antenatal and intra-partum care for the poor and disadvantaged women. A critical gap in our knowledge is whether this cadre of workers, operating in the private health care context, will meet the expectation to provide care to the poorest and most marginalized women. There is an inherent paradox between the notions of fee-for-service and increasing access to health care for the poorest who, by definition, are unable to pay. Data will be collected in three interlinked modules. Module 1 will consist of a population-based survey in the catchment areas of the CMW's in districts Jhelum and Layyah in Punjab. Proportions of socially excluded women who are served by CMWs and their satisfaction levels with their maternity care provider will be assessed. Module 2 will explore, using an institutional ethnographic approach, the challenges (organizational, social, financial) that CMWs face in providing care to the poor and socially marginalized women. Module 3 will identify the social, financial, geographical and other barriers to uncover the hidden forces and power relations that shape the choices and opportunities of poor and marginalized women in accessing CMW services. An extensive knowledge dissemination plan will facilitate uptake of research findings to inform positive developments in maternal health policy, service design and care delivery in Pakistan. The findings of this study will enhance understanding of the power dynamics of gender and class that may underlie poor women's marginalization from health care systems, including community midwifery care. One key outcome will be an increased sensitization

  2. Are community midwives addressing the inequities in access to skilled birth attendance in Punjab, Pakistan? Gender, class and social exclusion

    Directory of Open Access Journals (Sweden)

    Mumtaz Zubia

    2012-09-01

    Full Text Available Abstract Background Pakistan is one of the six countries estimated to contribute to over half of all maternal deaths worldwide. To address its high maternal mortality rate, in particular the inequities in access to maternal health care services, the government of Pakistan created a new cadre of community-based midwives (CMW. A key expectation is that the CMWs will improve access to skilled antenatal and intra-partum care for the poor and disadvantaged women. A critical gap in our knowledge is whether this cadre of workers, operating in the private health care context, will meet the expectation to provide care to the poorest and most marginalized women. There is an inherent paradox between the notions of fee-for-service and increasing access to health care for the poorest who, by definition, are unable to pay. Methods/Design Data will be collected in three interlinked modules. Module 1 will consist of a population-based survey in the catchment areas of the CMW’s in districts Jhelum and Layyah in Punjab. Proportions of socially excluded women who are served by CMWs and their satisfaction levels with their maternity care provider will be assessed. Module 2 will explore, using an institutional ethnographic approach, the challenges (organizational, social, financial that CMWs face in providing care to the poor and socially marginalized women. Module 3 will identify the social, financial, geographical and other barriers to uncover the hidden forces and power relations that shape the choices and opportunities of poor and marginalized women in accessing CMW services. An extensive knowledge dissemination plan will facilitate uptake of research findings to inform positive developments in maternal health policy, service design and care delivery in Pakistan. Discussion The findings of this study will enhance understanding of the power dynamics of gender and class that may underlie poor women’s marginalization from health care systems, including

  3. Skilled Birth Attendants: who is who? A descriptive study of definitions and roles from nine Sub Saharan African countries.

    Science.gov (United States)

    Adegoke, Adetoro; Utz, Bettina; Msuya, Sia E; van den Broek, Nynke

    2012-01-01

    Availability of a Skilled Birth Attendant (SBA) during childbirth is a key indicator for MDG5 and a strategy for reducing maternal and neonatal mortality in Africa. There is limited information on how SBAs and their functions are defined. The aim of this study was to map the cadres of health providers considered SBAs in Sub Saharan Africa (SSA); to describe which signal functions of Essential Obstetric Care (EmOC) they perform and assess whether they are legislated to perform these functions. Key personnel in the Ministries of Health, teaching institutions, referral, regional and district hospitals completed structured questionnaires in nine SSA countries in 2009-2011. A total of 21 different cadres of health care providers (HCP) were reported to be SBA. Type and number of EmOC signal functions reported to be provided, varied substantially between cadres and countries. Parenteral antibiotics, uterotonic drugs and anticonvulsants were provided by most SBAs. Removal of retained products of conception and assisted vaginal delivery were the least provided signal functions. Except for the cadres of obstetricians, medical doctors and registered nurse-midwives, there was lack of clarity regarding signal functions reported to be performed and whether they were legislated to perform these. This was particularly for manual removal of placenta, removal of retained products and assisted vaginal delivery. In some countries, cadres not considered SBA performed deliveries and provided EmOC signal functions. In other settings, cadres reported to be SBA were able to but not legislated to perform key EmOC signal functions. Comparison of cadres of HCPs reported to be SBA across countries is difficult because of lack of standardization in names, training, and functions performed. There is a need for countries to develop clear guidelines defining who is a SBA and which EmOC signal functions each cadre of HCP is expected to provide.

  4. Skilled Birth Attendants: who is who? A descriptive study of definitions and roles from nine Sub Saharan African countries.

    Directory of Open Access Journals (Sweden)

    Adetoro Adegoke

    Full Text Available BACKGROUND: Availability of a Skilled Birth Attendant (SBA during childbirth is a key indicator for MDG5 and a strategy for reducing maternal and neonatal mortality in Africa. There is limited information on how SBAs and their functions are defined. The aim of this study was to map the cadres of health providers considered SBAs in Sub Saharan Africa (SSA; to describe which signal functions of Essential Obstetric Care (EmOC they perform and assess whether they are legislated to perform these functions. METHODS AND FINDINGS: Key personnel in the Ministries of Health, teaching institutions, referral, regional and district hospitals completed structured questionnaires in nine SSA countries in 2009-2011. A total of 21 different cadres of health care providers (HCP were reported to be SBA. Type and number of EmOC signal functions reported to be provided, varied substantially between cadres and countries. Parenteral antibiotics, uterotonic drugs and anticonvulsants were provided by most SBAs. Removal of retained products of conception and assisted vaginal delivery were the least provided signal functions. Except for the cadres of obstetricians, medical doctors and registered nurse-midwives, there was lack of clarity regarding signal functions reported to be performed and whether they were legislated to perform these. This was particularly for manual removal of placenta, removal of retained products and assisted vaginal delivery. In some countries, cadres not considered SBA performed deliveries and provided EmOC signal functions. In other settings, cadres reported to be SBA were able to but not legislated to perform key EmOC signal functions. CONCLUSIONS: Comparison of cadres of HCPs reported to be SBA across countries is difficult because of lack of standardization in names, training, and functions performed. There is a need for countries to develop clear guidelines defining who is a SBA and which EmOC signal functions each cadre of HCP is expected to

  5. Economic inequalities in maternal health care: prenatal care and skilled birth attendance in India, 1992-2006.

    Directory of Open Access Journals (Sweden)

    Praveen Kumar Pathak

    Full Text Available BACKGROUND: The use of maternal health care is limited in India despite several programmatic efforts for its improvement since the late 1980's. The use of maternal health care is typically patterned on socioeconomic and cultural contours. However, there is no clear perspective about how socioeconomic differences over time have contributed towards the use of maternal health care in India. METHODOLOGY/PRINCIPAL FINDINGS: Using data from three rounds of National Family Health Survey (NFHS conducted during 1992-2006, we analyse the trends and patterns in utilization of prenatal care (PNC in first trimester with four or more antenatal care visits and skilled birth attendance (SBA among poor and nonpoor mothers, disaggregated by area of residence in India and three contrasting provinces, namely, Uttar Pradesh, Maharashtra and Tamil Nadu. In addition, we investigate the relative contribution of public and private health facilities in meeting the demand for SBA, especially among poor mothers. We also examine the role of salient socioeconomic, demographic and cultural factors in influencing aforementioned outcomes. Bivariate analyses, concentration curve and concentration index, logistic regression and multinomial logistic regression models are used to understand the trends, patterns and predictors of the two outcome variables. Results indicate sluggish progress in utilization of PNC and SBA in India and selected provinces during 1992-2006. Enormous inequalities in utilization of PNC and SBA were observed largely to the disadvantage of the poor. Multivariate analysis suggests growing inequalities in utilization of the two outcomes across different economic groups. CONCLUSIONS: The use of PNC and SBA remains disproportionately lower among poor mothers in India irrespective of area of residence and province. Despite several governmental efforts to increase access and coverage of delivery services to poor, it is clear that the poor (a do not use SBA and (b

  6. Do the early development of gestures and receptive and expressive language predict language skills at 5;0 in prematurely born very-low-birth-weight children?

    Science.gov (United States)

    Stolt, S; Lind, A; Matomäki, J; Haataja, L; Lapinleimu, H; Lehtonen, L

    2016-01-01

    It is unclear what the predictive value of very early development of gestures and language is on later language ability in prematurely born very-low-birth-weight (VLBW; birth weight ≤1500g) children. The aim of the present study was to analyse the predictive value of early gestures and a receptive lexicon measured between the ages of 0;9 and 1;3, as well as the predictive value of receptive and expressive language ability at 2;0 for language skills at 5;0 in VLBW children. The subjects were 29 VLBW children and 28 full-term children whose language development has been followed intensively between the ages of 0;9 and 2;0 using the Finnish version of the MacArthur Developmental Inventory and the Reynell Developmental Language Scales (RDLS III). At 5;0, five selected verbal subtests of the Nepsy II test and the Boston Naming Test (BNT) were used to assess children's language skills. For the first time in VLBW children, the development of gestures measured between the ages of 0;9 and 1;3 was shown to correlate significantly and positively with language skills at 5;0. In addition, both receptive and expressive language ability measured at 2;0 correlated significantly and positively with later language skills in both groups. Moreover, according to the hierarchical regression analysis, the receptive language score of the RDLS III at 2;0 was a clear and significant predictor for language skills at 5;0 in both groups. The findings particularly underline the role of early receptive language as a significant predictor for later language ability in VLBW children. The results provide evidence for a continuity between early language development and later language skills. After reading this article, readers will understand the associations between the very early (≤2 years of age) development of gestures and language (i.e. early receptive lexicon, expressive lexicon at 2;0, receptive and expressive language ability at 2;0) and the language skills at 5;0 in prematurely born

  7. Why give birth in health facility? Users’ and providers’ accounts of poor quality of birth care in Tanzania

    Science.gov (United States)

    2013-01-01

    Background In Tanzania, half of all pregnant women access a health facility for delivery. The proportion receiving skilled care at birth is even lower. In order to reduce maternal mortality and morbidity, the government has set out to increase health facility deliveries by skilled care. The aim of this study was to describe the weaknesses in the provision of acceptable and adequate quality care through the accounts of women who have suffered obstetric fistula, nurse-midwives at both BEmOC and CEmOC health facilities and local community members. Methods Semi-structured interviews involving 16 women affected by obstetric fistula and five nurse-midwives at maternity wards at both BEmOC and CEmOC health facilities, and Focus Group Discussions with husbands and community members were conducted between October 2008 and February 2010 at Comprehensive Community Based Rehabilitation in Tanzania and Temeke hospitals in Dar es Salaam, and Mpwapwa district in Dodoma region. Results Health care users and health providers experienced poor quality caring and working environments in the health facilities. Women in labour lacked support, experienced neglect, as well as physical and verbal abuse. Nurse-midwives lacked supportive supervision, supplies and also seemed to lack motivation. Conclusions There was a consensus among women who have suffered serious birth injuries and nurse midwives staffing both BEmOC and CEmOC maternity wards that the quality of care offered to women in birth was inadequate. While the birth accounts of women pointed to failure of care, the nurses described a situation of disempowerment. The bad birth care experiences of women undermine the reputation of the health care system, lower community expectations of facility birth, and sustain high rates of home deliveries. The only way to increase the rate of skilled attendance at birth in the current Tanzanian context is to make facility birth a safer alternative than home birth. The findings from this study

  8. Jhaukhel-Duwakot Health Demographic Surveillance Site, Nepal: 2012 follow-up survey and use of skilled birth attendants

    Directory of Open Access Journals (Sweden)

    Bishnu P. Choulagai

    2015-12-01

    Full Text Available Background: Estimates of disease burden in Nepal are based on cross-sectional studies that provide inadequate epidemiological information to support public health decisions. This study compares the health and demographic indicators at the end of 2012 in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS with the baseline conducted at the end of 2010. We also report on the use of skilled birth attendants (SBAs and associated factors in the JD-HDSS at the follow-up point. Design: We used a structured questionnaire to survey 3,505 households in the JD-HDSS, Bhaktapur, Nepal. To investigate the use of SBAs, we interviewed 434 women who had delivered a baby within the prior 2 years. We compared demographic and health indicators at baseline and follow-up and assessed the association of SBA services with background variables. Results: Due to rising in-migration, the total population and number of households in the JD-HDSS increased (13,669 and 2,712 in 2010 vs. 16,918 and 3,505 in 2012. Self-reported morbidity decreased (11.1% vs. 7.1%, respectively, whereas accidents and injuries increased (2.9% vs. 6.5% of overall morbidity, respectively. At follow-up, the proportion of institutional delivery (93.1% exceeded the national average (36%. Women who accessed antenatal care and used transport (e.g. bus, taxi, motorcycle to reach a health facility were more likely to access institutional delivery. Conclusions: High in-migration increased the total population and number of households in the JD-HDSS, a peri-urban area where most health indicators exceed the national average. Major morbidity conditions (respiratory diseases, fever, gastrointestinal problems, and bone and joint problems remain unchanged. Further investigation of reasons for increased proportion of accidents and injuries are recommended for their timely prevention. More than 90% of our respondents received adequate antenatal care and used institutional delivery, but only 13

  9. Community-based recreational football

    DEFF Research Database (Denmark)

    Bruun, Ditte Marie; Bjerre, Eik; Krustrup, Peter

    2014-01-01

    is limited and the majority of prostate cancer survivors remain sedentary. Hence, novel approaches to evaluate and promote physical activity are warranted. This paper presents the rationale behind the delivery and evaluation of community-based recreational football offered in existing football clubs under...... the Danish Football Association to promote quality of life and physical activity adherence in prostate cancer survivors. The RE-AIM framework will be applied to evaluate the impact of the intervention including outcomes both at the individual and organizational level. By introducing community-based sport...

  10. National Migrant Education Program: Early Childhood Development Skills--Birth Through 5 Years (Desarrollo de Destrezas en la Temprana Infancia--Desde el Nacimiento Hasta los Cinco Anos de Edad).

    Science.gov (United States)

    1979

    Compiled to ensure cooperation between states and to provide continuity of reporting on developmental skills for the migrant child from birth through five years of age, this booklet lists the psychomotor, cognitive, and affective skills which are reported through the Migrant Student Record Transfer System (MSRTS). Published in both English and…

  11. National Migrant Education Program: Early Childhood Development Skills--Birth Through 5 Years (Desarrollo de Destrezas en la Temprana Infancia--Desde el Nacimiento Hasta los Cinco Anos de Edad).

    Science.gov (United States)

    1979

    Compiled to ensure cooperation between states and to provide continuity of reporting on developmental skills for the migrant child from birth through five years of age, this booklet lists the psychomotor, cognitive, and affective skills which are reported through the Migrant Student Record Transfer System (MSRTS). Published in both English and…

  12. Association of Household Savings and Expected Future Means with Delivery Using a Skilled Birth Attendant in Ghana and Nigeria: A Cross-Sectional Analysis.

    Science.gov (United States)

    Jennings, Larissa; Yang, Fan; Otupiri, Easmon; Akinlo, Ambrose; Okunlola, Michael; Hindin, Michelle

    2017-01-01

    Objectives This study examined the association between household savings and related economic measures with utilization of skilled birth attendants (SBAs) at last birth among women living in peri-urban households (n = 381) in Ghana and Nigeria. Methods Data were drawn from the 2011-2014 Family Health and Wealth Study. Multivariable logistic regression models were used to estimate the odds of delivery with an SBA for individual and composite measures of household savings, expected financial means, debt, lending, and receipt of financial assistance, adjusting for demographic and reproductive characteristics. Results Seventy-three percent (73 %) of women delivered with an SBA during their last birth (89 %, Ghana; 63 %, Nigeria), and roughly one third (34 %) of households reported having any in-cash or in-kind savings. In adjusted analyses, women living in households with savings were significantly more likely to deliver with an SBA compared to women in households without any savings (aOR = 2.02, 95 % CI 1.09-3.73). There was also a consistent downward trend, although non-significant, in SBA utilization with worsening financial expectations in the coming year (somewhat vs. much better: aOR = 0.70, 95 % CI 0.40-1.22 and no change/worse vs. much better: aOR = 0.46, 95 % CI 0.12-1.83). Findings were null for measures relating to debt, lending, and financial assistance. Conclusion Coupling birth preparedness and complication readiness strategies with savings-led initiatives may improve SBA utilization in conjunction with targeting non-economic barriers to skilled care use.

  13. Fostering Sociopolitical Consciousness with Minoritized Youth: Insights from Community-Based Arts Programs

    Science.gov (United States)

    Ngo, Bic; Lewis, Cynthia; Maloney Leaf, Betsy

    2017-01-01

    In this chapter, we review the literature on community-based arts programs serving minoritized youth to identify the conditions and practices for fostering sociopolitical consciousness. Community-based arts programs have the capacity to promote teaching and learning practices in ways that engage youth in the use of academic skills to pursue…

  14. Assessing Community Based Improved Maternal Neonatal Child Survival (IMNCS Program in Rural Bangladesh.

    Directory of Open Access Journals (Sweden)

    Mahfuzar Rahman

    Full Text Available A community based approach before, during and after child birth has been proven effective address the burden of maternal, neonatal and child morbidity and mortality in the low and middle income countries. We aimed to examine the overall change in maternal and newborn health outcomes due the "Improved Maternal Newborn and Child Survival" (IMNCS project, which was implemented by BRAC in rural communities of Bangladesh.The intervention was implemented in four districts for duration of 5-years, while two districts served as comparison areas. The intervention was delivered by community health workers who were trained on essential maternal, neonatal and child health care services. A baseline survey was conducted in 2008 among 7, 200 women with pregnancy outcome in last year or having a currently alive child of 12-59 months. A follow-up survey was administered in 2012-13 among 4, 800 women of similar characteristics in the same villages.We observed significant improvements in maternal and essential newborn care in intervention areas over time, especially in health care seeking behaviors. The proportion of births taking place at home declined in the intervention districts from 84.3% at baseline to 71.2% at end line (P<0.001. Proportion of deliveries with skilled attendant was higher in intervention districts (28% compared to comparison districts (27.4%. The number of deliveries was almost doubled at public sector facility comparing with baseline (P<0.001. Significant improvement was also observed in healthy cord care practice, delayed bathing of the new-born and reduction of infant mortality in intervention districts compared to that of comparison districts.This study demonstrates that community-based efforts offer encouraging evidence and value for combining maternal, neonatal and child health care package. This approach might be considered at larger scale in similar settings with limited resources.

  15. Accelerated Training of Skilled Birth Attendants in a Marginalized Population on the Thai-Myanmar Border: A Multiple Methods Program Evaluation

    Science.gov (United States)

    White, Adrienne Lynne; Min, Thaw Htwe; Gross, Mechthild M.; Kajeechiwa, Ladda; Thwin, May Myo; Hanboonkunupakarn, Borimas; Than, Hla Hla; Zin, Thet Wai; Rijken, Marcus J.; Hoogenboom, Gabie; McGready, Rose

    2016-01-01

    Background To evaluate a skilled birth attendant (SBA) training program in a neglected population on the Thai-Myanmar border, we used multiple methods to show that refugee and migrant health workers can be given effective training in their own environment to become SBAs and teachers of SBAs. The loss of SBAs through resettlement to third countries necessitated urgent training of available workers to meet local needs. Methods and Findings All results were obtained from student records of theory grades and clinical log books. Qualitative evaluation of both the SBA and teacher programs was obtained using semi-structured interviews with supervisors and teachers. We also reviewed perinatal indicators over an eight-year period, starting prior to the first training program until after the graduation of the fourth cohort of SBAs. Results Four SBA training programs scheduled between 2009 and 2015 resulted in 79/88 (90%) of students successfully completing a training program of 250 theory hours and 625 supervised clinical hours. All 79 students were able to: achieve pass grades on theory examination (median 80%, range [70–89]); obtain the required clinical experience within twelve months; achieve clinical competence to provide safe care during childbirth. In 2010–2011, five experienced SBAs completed a train-the-trainer (TOT) program and went on to facilitate further training programs. Perinatal indicators within Shoklo Malaria Research Unit (SMRU), such as place of birth, maternal and newborn outcomes, showed no significant differences before and after introduction of training or following graduate deployment in the local maternity units. Confidence, competence and teamwork emerged from qualitative evaluation by senior SBAs working with and supervising students in the clinics. Conclusions We demonstrate that in resource-limited settings or in marginalized populations, it is possible to accelerate training of skilled birth attendants to provide safe maternity care

  16. Helping Mothers Survive Bleeding After Birth : retention of knowledge, skills, and confidence nine months after obstetric simulation-based training

    NARCIS (Netherlands)

    Nelissen, Ellen; Ersdal, Hege; Mduma, Estomih; Evjen-Olsen, Bjorg; Broerse, Jacqueline; van Roosmalen, Jos; Stekelenburg, Jelle

    2015-01-01

    Background: It is important to know the decay of knowledge, skills, and confidence over time to provide evidence-based guidance on timing of follow-up training. Studies addressing retention of simulation-based education reveal mixed results. The aim of this study was to measure the level of

  17. Helping Mothers Survive Bleeding After Birth : retention of knowledge, skills, and confidence nine months after obstetric simulation-based training

    NARCIS (Netherlands)

    Nelissen, Ellen; Ersdal, Hege; Mduma, Estomih; Evjen-Olsen, Bjorg; Broerse, Jacqueline; van Roosmalen, Jos; Stekelenburg, Jelle

    2015-01-01

    Background: It is important to know the decay of knowledge, skills, and confidence over time to provide evidence-based guidance on timing of follow-up training. Studies addressing retention of simulation-based education reveal mixed results. The aim of this study was to measure the level of knowledg

  18. Identifying Effective Methods of Instruction for Adult Emergent Readers through Community-Based Research

    Science.gov (United States)

    Blackmer, Rachel; Hayes-Harb, Rachel

    2016-01-01

    We present a community-based research project aimed at identifying effective methods and materials for teaching English literacy skills to adult English as a second language emergent readers. We conducted a quasi-experimental study whereby we evaluated the efficacy of two approaches, one based on current practices at the English Skills Learning…

  19. Identifying Effective Methods of Instruction for Adult Emergent Readers through Community-Based Research

    Science.gov (United States)

    Blackmer, Rachel; Hayes-Harb, Rachel

    2016-01-01

    We present a community-based research project aimed at identifying effective methods and materials for teaching English literacy skills to adult English as a second language emergent readers. We conducted a quasi-experimental study whereby we evaluated the efficacy of two approaches, one based on current practices at the English Skills Learning…

  20. Service Learning and Community-Based Partnerships: A Model for Teaching Macro Practice Social Work

    Science.gov (United States)

    Nandan, Monica; Scott, Patricia

    2011-01-01

    This article describes an innovative project that combined service learning and community-based partnerships to teach macro practice skills to social work students and citizenship skills to primary school students. The partners, a small social work program, several primary schools, and an internationally recognized civic engagement program,…

  1. Community-Based Integrated Watershed Management

    Institute of Scientific and Technical Information of China (English)

    Li Qianxiang; Kennedy N.logbokwe; Li Jiayong

    2005-01-01

    Community-based watershed management is different from the traditional natural resources management. Traditional natural resources management is a way from up to bottom, but the community-based watershed management is from bottom to up. This approach focused on the joining of different stakeholders in integrated watershed management, especially the participation of the community who has been ignored in the past. The purpose of this paper is to outline some of the important basic definitions, concepts and operational framework for initiating community-based watershed management projects and programs as well as some successes and practical challenges associated with the approach.

  2. COMMUNITY BASED ECOTOURISM MANAGEMENT PRACTISE, A ...

    African Journals Online (AJOL)

    larry

    Development Indicators (SDI) selected to assess the impacts of Community Based Ecotourism. Management ... social capital and infrastructural facilities. Demographic ... Ecotourism is a responsible form of tourism ...... Lumpur, Malaysia. Jones ...

  3. Community-Based Social Marketing Training Guide

    Science.gov (United States)

    The Community-Based Social Marketing (CBSM) Training Guide and recycling toolkit provides an overview of how to increase the adoption of sustainable behaviors and recycling practices with a community.

  4. Community Based Networks and 5G

    DEFF Research Database (Denmark)

    Williams, Idongesit

    2016-01-01

    The deployment of previous wireless standards has provided more benefits for urban dwellers than rural dwellers. 5G deployment may not be different. This paper identifies that Community Based Networks as carriers that deserve recognition as potential 5G providers may change this. The argument...... is hinged on a research aimed at understanding how and why Community Based Networks deploy telecom and Broadband infrastructure. The study was a qualitative study carried out inductively using Grounded Theory. Six cases were investigated.Two Community Based Network Mobilization models were identified....... The findings indicate that 5G connectivity can be extended to rural areas by these networks, via heterogenous networks. Hence the delivery of 5G data rates delivery via Wireless WAN in rural areas can be achieved by utilizing the causal factors of the identified models for Community Based Networks....

  5. Effect of community-based comprehensive interventions on first aid skills and the level of serf-efficacy in the elderly%社区综合干预对老年人急救技能及自我效能水平的影响

    Institute of Scientific and Technical Information of China (English)

    姚红瑛; 叶志弘; 朱丽华; 骆国妹; 康培红

    2013-01-01

    of them were investigated with the first aid knowledge questionnaire and self-efficacy scale for the elderly in community on the levels of first aid knowledge and selfefficacy.All participants received six-month community-based comprehensive interventions,and the levels of first aid knowledge and self-efficacy were compared between before the intervention,and 3 and 6 months after the intervention.In addition,the emergency situation and implementation effects of community-based comprehensive interventions within six-month interventions were investigated with the first-aid skills training followed up questionnaire.Results A total of 184 questionnaires were distributed and 184 valid questionnaires were returned,resulting in a response rate of 100%,and four elderly people were lost to follow up,180 valid questionnaires were finally obtained.Before the intervention,there were 77.8% in 180 elderly people in the community who had not previously received training in first aid knowledge and skills,and 87.2% elderly people who could not perform cardiopulmonary resuscitation (CPR).Six months after the intervention,the score of first aid knowledge of the elderly in community increased from (48.06 ± 16.17) to (82.50 ± 15.28),the score of self-efficacy increased from (24.07 ± 6.62) to (30.86 ± 5.21),and there were significant differences between before and after the intervention (F =303.475,264.404,respectively; P < 0.05).The scores of first aid knowledge and self-efficacy in each dimension in the elderly,who had different gender,age,educational level,living style,previous history of occupation and chronic diseases,increased when the intervention time was prolonged.Conclusions The first aid baseline survey finds that the level of first aid knowledge in community elderly is still far from satisfactory.The application of community-based comprehensive interventions can strengthen the first aid knowledge and improve the level of self-efficacy in the elderly.

  6. Community-based misoprostol for the prevention of post-partum haemorrhage: A narrative review of the evidence base, challenges and scale-up.

    Science.gov (United States)

    Hobday, Karen; Hulme, Jennifer; Belton, Suzanne; Homer, Caroline Se; Prata, Ndola

    2017-03-30

    Achieving Sustainable Development Goal targets for 2030 will require persistent investment and creativity in improving access to quality health services, including skilled attendance at birth and access to emergency obstetric care. Community-based misoprostol has been extensively studied and recently endorsed by the WHO for the prevention of post-partum haemorrhage. There remains little consolidated information about experience with implementation and scale-up to date. This narrative review of the literature aimed to identify the political processes leading to WHO endorsement of misoprostol for the prevention of post-partum haemorrhage and describe ongoing challenges to the uptake and scale-up at both policy and community levels. We review the peer-reviewed and grey literature on expansion and scale-up and present the issues central to moving forward.

  7. Birth Control

    Science.gov (United States)

    Birth control, also known as contraception, is designed to prevent pregnancy. Birth control methods may work in a number of different ... eggs that could be fertilized. Types include birth control pills, patches, shots, vaginal rings, and emergency contraceptive ...

  8. Community-based knowledge translation: unexplored opportunities

    Directory of Open Access Journals (Sweden)

    Armstrong Rebecca

    2011-06-01

    Full Text Available Abstract Background Knowledge translation is an interactive process of knowledge exchange between health researchers and knowledge users. Given that the health system is broad in scope, it is important to reflect on how definitions and applications of knowledge translation might differ by setting and focus. Community-based organizations and their practitioners share common characteristics related to their setting, the evidence used in this setting, and anticipated outcomes that are not, in our experience, satisfactorily reflected in current knowledge translation approaches, frameworks, or tools. Discussion Community-based organizations face a distinctive set of challenges and concerns related to engaging in the knowledge translation process, suggesting a unique perspective on knowledge translation in these settings. Specifically, community-based organizations tend to value the process of working in collaboration with multi-sector stakeholders in order to achieve an outcome. A feature of such community-based collaborations is the way in which 'evidence' is conceptualized or defined by these partners, which may in turn influence the degree to which generalizable research evidence in particular is relevant and useful when balanced against more contextually-informed knowledge, such as tacit knowledge. Related to the issues of evidence and context is the desire for local information. For knowledge translation researchers, developing processes to assist community-based organizations to adapt research findings to local circumstances may be the most helpful way to advance decision making in this area. A final characteristic shared by community-based organizations is involvement in advocacy activities, a function that has been virtually ignored in traditional knowledge translation approaches. Summary This commentary is intended to stimulate further discussion in the area of community-based knowledge translation. Knowledge translation, and exchange

  9. Feasibility of pulse oximetry for assessment of infants born in community based midwifery care.

    Science.gov (United States)

    Smit, Marrit; Ganzeboom, Angelina; Dawson, Jennifer A; Walther, Frans J; Bustraan, Jacqueline; van Roosmalen, Jos J M; te Pas, Arjan B

    2014-05-01

    to evaluate the feasibility of using pulse oximetry (PO) for evaluating infants born in community-based midwifery care. a prospective, observational study of infants born after midwifery supervised (home) births. 27 midwives from seven practices providing primary care in (home) births used PO at birth or the early puerperal period over a ten-month period. Data were obtained on the effect of PO on outcome, interventions and decision-making. Midwives were surveyed about applicability and usefulness of PO. 153 infants born in primary midwifery care. all births were uncomplicated except for one infant receiving supplemental oxygen and another was mask ventilated. In 138/153 (90%) infants PO was successfully used and 88% of midwives found PO easy to use. In 148/153 (97%) infants PO did not influence midwives' clinical judgment and referral policy. In 5/153 (3%) infants, midwives were uncertain of the infant's condition, but PO measurements were reassuring. In case of suboptimal neonatal condition or resuscitation, 100% of midwives declared they would use PO again. it is feasible to use PO in community based midwifery care, but not considered an important contribution to routine evaluation of infants. Midwives would like to have PO available during suboptimal neonatal condition or when resuscitation is required. PO can be applied in community based midwifery care; it does not lead to insecurity or extra referral. Further research on a larger group of infants must show the effect of PO on neonatal outcomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. An evaluation of equitable access to a community-based maternal and newborn health program in rural Ethiopia.

    Science.gov (United States)

    Spangler, Sydney A; Barry, Danika; Sibley, Lynn

    2014-01-01

    The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) aimed to promote equitable access to safe childbirth and postnatal care through a community-based educational intervention. This study evaluates the extent to which MaNHEP reached women who are socially and materially disadvantaged and, thus, at high risk for inadequate access to care. The data used in this analysis are from MaNHEP's cross-sectional 2010 baseline and 2012 endline surveys of women who gave birth in the prior year. A logistic regression model was fit to examine the effects of sociodemographic characteristics on participation in the MaNHEP program. Descriptive statistics of select characteristics by birth and postnatal care provider were also calculated to explore trends in services use. Using data from the endline survey (N = 1019), the regression model showed that age, parity, education, and geographic residence were not significantly associated with MaNHEP exposure. However, women who were materially disadvantaged were still less likely to have participated in the program than their better-off counterparts. From the baseline survey (N = 1027) to the endline survey, women's use of skilled and semiskilled providers for birth care and postnatal care increased substantially, while use of untrained providers or no provider decreased. These shifts were greater for women with less personal wealth than for women with more personal wealth. MaNHEP appears to have succeeded in meeting its equity goals to a degree. However, this study also supports the intractable relationship between wealth inequality and access to maternal and newborn health services. Strategies targeting the poor in diverse contexts may eventually prove consistently effective in equitable services delivery. Until that time, a critical step that all maternal and newborn health programs can take is to monitor and evaluate to what extent they are reaching disadvantaged groups within the populations they serve. © 2013 by the

  11. When You Can't Get out: "Strategies for Supporting Community-Based Instruction"

    Science.gov (United States)

    Steere, Daniel E.; DiPipi-Hoy, Caroline

    2012-01-01

    Although community-based instruction (CBI) is an essential component of an effective educational program for students with severe disabilities, teachers frequently struggle to implement such instruction on a frequent and consistent enough basis for students to learn functional skills quickly and efficiently. This article describes evidence-based…

  12. Pivot Points: Direct Measures of the Content and Process of Community-Based Learning

    Science.gov (United States)

    Wickersham, Carol; Westerberg, Charles; Jones, Karen; Cress, Margaret

    2016-01-01

    This research is an initial investigation into the ways community-based learning increase the cognitive skills central to the exercise of the sociological imagination. In addition to identifying a means to reveal that learning had occurred, we looked for evidence that the students were mastering sociological content, especially the concepts and…

  13. Reflections on Ideological Consistency between Community-Based Research and Counselling Practice

    Science.gov (United States)

    Harris, Gregory E.

    2009-01-01

    Community-based research (CBR) and counselling practice share multiple skill sets and ideological tenets. In addition, CBR offers an approach to research that can be highly conducive to effective counselling-related research. Despite these consistencies and benefits, counsellors and counselling students have underutilized this approach to…

  14. Role Model Ambulatory Care Clinical Training Site in a Community-Based Pharmacy.

    Science.gov (United States)

    Magarian, Edward O.; And Others

    1993-01-01

    An interdisciplinary project provided ambulatory care clinical training for pharmacy and nursing students in community-based pharmacies, promoting early detection and medical follow-up of common health problems within the community. Students learned new clinical skills in patient health assessment, new diagnostic technologies, patient education…

  15. Career Advancement for Low-Income Workers through Community College and Community-Based Organization Partnerships.

    Science.gov (United States)

    Roberts, Brandon

    An increasing number of community colleges (CCs) and community-based organizations (CBOs) are now working in partnership to develop education and training programs enabling low-income workers to gain the education and skills necessary to obtain higher-wage jobs and develop a foundation for lifelong learning and career advancement. The following…

  16. Exploring the Benefits of Community-Based Research in a Sociology of Sexualities Course

    Science.gov (United States)

    Bach, Rebecca; Weinzimmer, Julianne

    2011-01-01

    The benefits of community-based research (CBR) in the sociology classroom go beyond those associated with traditional service learning. Here, students use their sociological skills to examine and propose solutions to local social problems addressed by community organizations. Through analyzing students' course reflection journals and the results…

  17. Exploring the Benefits of Community-Based Research in a Sociology of Sexualities Course

    Science.gov (United States)

    Bach, Rebecca; Weinzimmer, Julianne

    2011-01-01

    The benefits of community-based research (CBR) in the sociology classroom go beyond those associated with traditional service learning. Here, students use their sociological skills to examine and propose solutions to local social problems addressed by community organizations. Through analyzing students' course reflection journals and the results…

  18. Lupus and community-based social work.

    Science.gov (United States)

    Schudrich, Wendy; Gross, Diane; Rowshandel, Jessica

    2012-01-01

    Systemic lupus erythematous (SLE) is a chronic autoimmune disease that disproportionately strikes women of color. SLE patients frequently experience physical, emotional, and social challenges that often result in unmet biopsychosocial needs. Because of the nature of the disease and the needs of patients, agencies serving SLE patients that engage in community-based social work can positively impact their clients' lives. The S.L.E. Lupus Foundation participates in a myriad of community-based social work practices to help address the needs of their clients. These services include helping economically disadvantaged patients access appropriate services within their communities, building awareness about SLE in society, connecting with government officials at all levels, and collaborating with health care organizations to serve those affected by SLE. Specific examples of community-based activities at the S.L.E. Lupus Foundation are described in detail.

  19. Community-based organizations in the health sector: A scoping review

    Directory of Open Access Journals (Sweden)

    Wilson Michael G

    2012-11-01

    Full Text Available Abstract Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues, we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry. We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff, the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks. Given the range of terms used to

  20. Birth Defects

    Science.gov (United States)

    A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of ... in the United States is born with a birth defect. A birth defect may affect how the ...

  1. 60 Million non-facility births: who can deliver in community settings to reduce intrapartum-related deaths?

    Science.gov (United States)

    Darmstadt, Gary L; Lee, Anne C C; Cousens, Simon; Sibley, Lynn; Bhutta, Zulfiqar A; Donnay, France; Osrin, Dave; Bang, Abhay; Kumar, Vishwajeet; Wall, Steven N; Baqui, Abdullah; Lawn, Joy E

    2009-10-01

    For the world's 60 million non-facility births, addressing who is currently attending these births and what effect they have on birth outcomes is a key starting point toward improving care during childbirth. We present a systematic review of evidence for the effect of community-based cadres-community-based skilled birth attendants (SBAs), trained traditional birth attendants (TBAs), and community health workers (CHWs)-in improving perinatal and intrapartum-related outcomes. The evidence for providing skilled birth attendance in the community is low quality, consisting of primarily before-and-after and quasi-experimental studies, with a pooled 12% reduction in all cause perinatal mortality (PMR) and a 22%-47% reduction in intrapartum-related neonatal mortality (IPR-NMR). Low/moderate quality evidence suggests that TBA training may improve linkages with facilities and improve perinatal outcomes. A randomized controlled trial (RCT) of TBA training showed a 30% reduction in PMR, and a meta-analysis demonstrated an 11% reduction in IPR-NMR. There is moderate evidence that CHWs have a positive impact on perinatal-neonatal outcomes. Meta-analysis of CHW packages (2 cluster randomized controlled trials, 2 quasi-experimental studies) showed a 28% reduction in PMR and a 36% reduction in early neonatal mortality rate; one quasi-experimental study showed a 42% reduction in IPR-NMR. Skilled childbirth care is recommended for all pregnant women, and community strategies need to be linked to prompt, high-quality emergency obstetric care. CHWs may play a promising role in providing pregnancy and childbirth care, mobilizing communities, and improving perinatal outcomes in low-income settings. While the role of the TBA is still controversial, strategies emphasizing partnerships with the health system should be further considered. Innovative community-based strategies combined with health systems strengthening may improve childbirth care for the rural poor, help reduce gross

  2. Community based curriculum in psychiatric nursing science

    OpenAIRE

    2012-01-01

    M.Cur. The purpose of this study is to describe guidelines for a Community Based Curriculum in Psychiatric Nursing Science for a nursing college in KwaZulu Natal. The study consists of 4 phases. To reach the purpose of the study, a situational analysis was done in 3 phases to identify the principles for a Community Based Curriculum in Psychiatric Nursing Science. In Phase I - a document analysis of relevant government policies and legislation was conducted to obtain the principles of menta...

  3. Community Based Networks and 5G

    DEFF Research Database (Denmark)

    Williams, Idongesit

    2016-01-01

    The deployment of previous wireless standards has provided more benefits for urban dwellers than rural dwellers. 5G deployment may not be different. This paper identifies that Community Based Networks as carriers that deserve recognition as potential 5G providers may change this. The argument....... The findings indicate that 5G connectivity can be extended to rural areas by these networks, via heterogenous networks. Hence the delivery of 5G data rates delivery via Wireless WAN in rural areas can be achieved by utilizing the causal factors of the identified models for Community Based Networks....

  4. Effect of a policy to reduce user fees on the rate of skilled birth attendance across socioeconomic strata in Burkina Faso

    Science.gov (United States)

    Langlois, Étienne V; Karp, Igor; Serme, Jean De Dieu; Bicaba, Abel

    2016-01-01

    Background. In Sub-Saharan Africa, maternal and neonatal morbidity and mortality rates are associated with underutilization of skilled birth attendance (SBA). In 2007, Burkina Faso introduced a subsidy scheme for SBA fees. The objective of this study was to evaluate the effect of Burkina Faso’s subsidy policy on SBA rate across socioeconomic status (SES) strata. Methods. We used a quasi-experimental design. The data sources were two representative surveys (n = 1408 and n = 1403) of women from Houndé and Ziniaré health districts of Burkina Faso, and a survey of health centres assessing structural quality of care. Multilevel Poisson regression models were used with robust variance estimators. We estimated adjusted rate ratios (RR) and rate differences (RD) as a function of time and SES. Results. For lowest-SES women, immediately upon the introduction of the subsidy policy, the rate of SBA was 45% higher (RR = 1.45, 95% confidence interval (CI): 1.19–1.77) than expected in the absence of subsidy introduction. The results indicated a sustained effect after introduction of the subsidy policy, based on RR estimate (95% CI) of 1.48 (1.21–1.81) at 2 years. For middle-SES women, the RR estimates were 1.28 (1.09–1.49) immediately after introduction of the subsidy policy and 1.30 (1.11–1.51) at 2 years, respectively. For highest-SES women, the RR estimates were 1.19 (1.02–1.38) immediately after subsidy introduction and 1.21 (1.06–1.38) at 2 years, respectively. The RD (95% CI) was 14% (3–24%) for lowest-SES women immediately after introduction of the policy, and the effect was sustained at 14% (4–25%) at 2 years. Conclusion. Our study suggests that the introduction of a user-fee subsidy in Burkina Faso resulted in increased rates of SBA across all SES strata. The increase was sustained over time and strongest among the poorest women. These findings have important implications for evidence-informed policymaking in Burkina Faso and other

  5. Embracing a competency-based specialty curriculum for community-based nursing roles.

    Science.gov (United States)

    Levin, Pamela F; Swider, Susan M; Breakwell, Susan; Cowell, Julia M; Reising, Virginia

    2013-01-01

    The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community-based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross-mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community-based specialties and (b) ensure the appropriateness of a Quad Council-based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross-mapping process, including validation with practice leaders. Results indicate strong alignment of community-based specialty competencies with Quad Council competencies. Community-based specialty-specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council-based curriculum is appropriate to prepare graduates in community-based specialties when attention to the specialty-specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community-based specialties.

  6. Recommendations for treating depression in community-based older adults.

    Science.gov (United States)

    Steinman, Lesley E; Frederick, John T; Prohaska, Thomas; Satariano, William A; Dornberg-Lee, Sharon; Fisher, Rita; Graub, Pearl Beth; Leith, Katherine; Presby, Kay; Sharkey, Joseph; Snyder, Susan; Turner, David; Wilson, Nancy; Yagoda, Lisa; Unutzer, Jurgen; Snowden, Mark

    2007-09-01

    To present recommendations for community-based treatment of late-life depression to public health and aging networks. An expert panel of mental health and public health researchers and community-based practitioners in aging was convened in April 2006 to form consensus-based recommendations. When making recommendations, panelists considered feasibility and appropriateness for community-based delivery, as well as strength of evidence on program effectiveness from a systematic literature review of articles published through 2005. The expert panel strongly recommended depression care management-modeled interventions delivered at home or at primary care clinics. The panel recommended individual cognitive behavioral therapy. Interventions not recommended as primary treatments for late-life depression included education and skills training, comprehensive geriatric health evaluation programs, exercise, and physical rehabilitation/occupational therapy. There was insufficient evidence for making recommendations for several intervention categories, including group psychotherapy and psychotherapies other than cognitive behavioral therapy. This interdisciplinary expert panel determined that recommended interventions should be disseminated throughout the public health and aging networks, while acknowledging the challenges and obstacles involved. Interventions that were not recommended or had insufficient evidence often did not treat depression primarily and/or did not include a clinically depressed sample while attempting to establish efficacy. These interventions may provide other benefits, but should not be presumed to effectively treat depression by themselves. Panelists also identified primary prevention of depression as a much under-studied area. These findings should aid individual clinicians as well as public health decision makers in the delivery of population-based mental health services in diverse community settings.

  7. Quality care for community-based FP / MCH.

    Science.gov (United States)

    1995-02-01

    The Regional Workshop on Quality Care for Community-based FP/MCH in Asia was organized by the Family Planning Association of Nepal (FPAN) in cooperation with JOICFP and held in Kathmandu, Nepal, December 4-9. Representatives of counterpart organizations in Bangladesh, Laos, Nepal, and the Philippines implementing the UNFPA-supported Sustainable Community-based FP/MCH Project with Special Focus on Women were included among the forty participants. Representatives of China and Vietnam as well as resource persons from Mexico and Japan also attended the event. The workshop was held with the goal of providing participants with effective strategies for promoting quality care for community-based FP/MCH activities based upon the Nepalese experience. The event also provided the opportunity for participants to share experiences, develop strategies for project sustainability, and identify strategies and action plans suitable for their particular country situations. In field trips to Panchkhal, Sunsari, and Morang where the project is being implemented in 26 villages, participants noted the strong community involvement and village leader support. They were also impressed by the communities' awareness of services provided under the project. FPAN has succeeded despite geographical and cultural difficulties in promoting fee-based services toward project sustainability. By paying nominal fees, villagers also enjoy access to drugs and services which may not have been available through the government free of charge. Participants at the end of the workshop recommended the identification of specific indicators and systems for monitoring services and activities, training and orientation at all levels to improve the skills and attitudes of health care workers, the development of potential income-generating activities, the provision of essential FP/MCH equipment, and the equal involvement of men and women at the policy and implementation levels.

  8. Cultivating Professional Allies for Sexual Minority Youth: A Community-Based Educational Intervention.

    Science.gov (United States)

    Craig, Shelley L; Doiron, Christopher; Dillon, Frank

    2015-01-01

    Sexual minority youth (SMY) face multiple risks in their daily lives that may influence their need for supportive care. Health and social service providers have unique opportunities to provide culturally competent services to these youth. This article describes a community-based educational intervention created to increase providers' knowledge, skills, and intention to support SMY. Based on the Information-Motivation-Behavioral Skills model, this pilot study found that for a diverse sample of multidisciplinary professionals (n = 2,850), the odds of behavioral intention (BI) to support SMY were significantly higher when trainings were relevant to the professionals' experience (OR = 1.3), were sensitive (OR = 1.3), developed skills (OR = 1.1), and incorporated policy (OR = 1.2). Implications for the delivery of community-based trainings are provided.

  9. Preterm Birth

    Science.gov (United States)

    ... is born too early, before 37 weeks of pregnancy have been completed. In 2015, preterm birth affected about 1 of every 10 infants born in the United States. Preterm birth rates decreased from 2007 to 2014, and CDC research shows ...

  10. Birth Injury

    Science.gov (United States)

    ... Are Up to Date Additional Content Medical News Birth Injury By Arthur E. Kopelman, MD, Professor of ... Problems in Newborns Overview of Problems in Newborns Birth Injury Prematurity Postmaturity Small for Gestational Age (SGA) ...

  11. Breech birth

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000623.htm Breech birth To use the sharing features on this page, ... safer for your baby to pass through the birth canal. In the last weeks of pregnancy, your ...

  12. Evaluating community-based public health leadership training.

    Science.gov (United States)

    Ceraso, Marion; Gruebling, Kirsten; Layde, Peter; Remington, Patrick; Hill, Barbara; Morzinski, Jeffrey; Ore, Peggy

    2011-01-01

    Addressing the nation's increasingly complex public health challenges will require more effective multisector collaboration and stronger public health leadership. In 2005, the Healthy Wisconsin Leadership Institute launched an annual, year-long intensive "community teams" program. The goal of this program is to develop collaborative leadership and public health skills among Wisconsin-based multisectoral teams mobilizing their communities to improve public health. To measure the scope of participation and program impacts on individual learning and practice, including application of new knowledge and collective achievements of teams on coalition and short-term community outcomes. End-of-year participant program evaluations and follow-up telephone interviews with participants 20 months after program completion. Community-based public health leadership training program. Sixty-eight participants in the Community Teams Program during the years 2006 to 2007 and 2007 to 2008. Professional diversity of program participants; individual learning and practice, including application of new knowledge; and collective achievements of teams, including coalition and short-term community outcomes. Participants in the Community Teams Program represent a diversity of sectors, including nonprofit, governmental, academic, business, and local public health. Participation increased knowledge across all public health and leadership competency areas covered in the program. Participating teams reported outcomes, including increased engagement of community leadership, expansion of preventive services, increased media coverage, strengthened community coalitions, and increased grant funding. Evaluation of this community-based approach to public health leadership training has shown it to be a promising model for building collaborative and public health leadership skills and initiating sustained community change for health improvement.

  13. Comparison of Knowledge on Diarrheal Disease Management between Two Types of Community-Based Distributors in Oyo State, Nigeria

    Science.gov (United States)

    Ande, Oluyinka; Oladepo, Oladimeji; Brieger, William R.

    2004-01-01

    Community-based distributors (CBDs) have been trained and utilized to promote a variety of health commodities. In addition, a variety of different types of community residents have been trained ranging from traditional birth attendants (TBAs) to patent medicine vendors. A training programme for CBD agents in the Akinyele Local Government Area of…

  14. Community-based natural resource management

    DEFF Research Database (Denmark)

    Treue, Thorsten; Nathan, Iben

    This technical note is the product of a long process of consultation with a wide range of resource persons who have over the years been involved in the Danish support to Community Based Natural Resource Management. It gives a brief introduction to community-based natural resource management (CBNRM......) and how this concept may be used as a development strategy. CBNRM has the triple objective of poverty reduction, natural resource conservation and good governance. The opportunity and challenge is to pursue these objectives simultaneously, as they are not, by default, mutually supportive. Lessons learnt......, resource conservation and good governance, and whether other resource management systems would be better will always be subject to context analysis and political debate. Accordingly, CBNRM is rather a development process and constant power struggle. Thus, even after years of implementation, donors...

  15. Using Photovoice with at-risk youth in a community-based cooking program.

    Science.gov (United States)

    Thomas, Heather Clarke; Irwin, Jennifer D

    2013-01-01

    We examined the facilitators of and barriers to participants' application of cooking skills beyond Cook It Up!, a pilot community-based cooking program targeting at-risk youth aged 13 to 18. Photovoice is a qualitative research method using still-picture cameras to document participants' health and community realities. Four participants photographed items they perceived as facilitators of or barriers to the application of cooking skills. At a facilitated discussion group, youth discussed why they took certain pictures and how the photos best exemplified facilitators and barriers. Participants agreed upon the themes arising from the dialogue. Data trustworthiness tools were used to ensure that themes arising from the dialogue truly represented participants' perspectives. Four major themes emerged as facilitators: aptitude, food literacy, local and fresh ingredients, and connectedness. Access to unhealthy foods was the only barrier that participants identified. Participants and researchers decided to advocate for the sustainability of community-based cooking programs offered for high school credit. Participants' photos would enhance advocacy efforts with education stakeholders. Cook It Up! provided youth with cooking techniques for healthy, economical, homemade meals, but proof was needed of the transferability of skills outside the program environment. Youth in this study identified important facilitators that enabled the continued use of their cooking skills, and one barrier. Findings underscore the importance of community-based cooking programs tailored to at-risk youth.

  16. Improving information for community-based adaptation

    Energy Technology Data Exchange (ETDEWEB)

    Huq, Saleemul

    2011-10-15

    Community-based adaptation aims to empower local people to cope with and plan for the impacts of climate change. In a world where knowledge equals power, you could be forgiven for thinking that enabling this type of adaptation boils down to providing local people with information. Conventional approaches to planning adaptation rely on 'expert' advice and credible 'science' from authoritative information providers such as the Intergovernmental Panel on Climate Change. But to truly support the needs of local communities, this information needs to be more site-specific, more user-friendly and more inclusive of traditional knowledge and existing coping practices.

  17. Improving information for community-based adaptation

    Energy Technology Data Exchange (ETDEWEB)

    Huq, Saleemul

    2011-10-15

    Community-based adaptation aims to empower local people to cope with and plan for the impacts of climate change. In a world where knowledge equals power, you could be forgiven for thinking that enabling this type of adaptation boils down to providing local people with information. Conventional approaches to planning adaptation rely on 'expert' advice and credible 'science' from authoritative information providers such as the Intergovernmental Panel on Climate Change. But to truly support the needs of local communities, this information needs to be more site-specific, more user-friendly and more inclusive of traditional knowledge and existing coping practices.

  18. PREVALENCE OF ADVERSE PREGNANCY OUTCOMES: A COMMUNITY BASED LONGITUDINAL STUDY

    Directory of Open Access Journals (Sweden)

    Vidya

    2015-06-01

    Full Text Available BACKGROUND: In most developed countries, pregnancies are planned, complications are few and outcomes are generally favorable for both mother and infant. But in developing countries, adverse pregnancy outcomes are far more frequent due to various reasons. T he most severe adverse outcome of pregnancy is the death of the mother or her offspring. Over the years maternal and child health programmes are striving to improve the health status of pregnant women and neonates. However, the adverse pregnancy outcomes ( M aternal and N eonatal still remain high. OBJECTIVE: To study the prevalence of adverse pregnancy in the study area. METHODOLOGY: A community based longitudinal study was carried out in the 36 villages of Kaiwara from January 2011 to December 2011. All the antenatal mothers were traced through Anganwadi records maintained at different villages. They were contacted at their residence and the questionnaire was administered in their local language. The questionnaire was administered during three different visi ts to collect information regarding socio - demographic details, pregnancy outcomes. The first visit was made before delivery and subsequently second and third visits were made within 7 days and 42 nd day after delivery respectively. Maternal and child protec tion cards were used to validate the collected information. Statistical analysis was performed using SPSS software version 18.0 RESULTS: The present study revealed that, the proportion of low birth weight in the study area was 31.9% (95% CI=25.74 - 38.06, p reterm birth 20.5% (95% CI=15.28 - 25.72, postnatal complications 5% (95% CI=14.819 - 9.181, abortion 2.1% (95% CI=0.25 - 3.95, maternal death 0.4% (95% CI=0.416 - 1.216 and neonatal death 0.4% (95% CI=0.416 - 1.216. CONCLUSION: The present study revealed that the proportion of adverse pregnancy outcomes was in par with the national average.

  19. Birth Weight

    Science.gov (United States)

    ... baby, taken just after he or she is born. A low birth weight is less than 5.5 pounds. A high ... weight is more than 8.8 pounds. A low birth weight baby can be born too small, too early (premature), or both. This ...

  20. Birthing Classes

    Science.gov (United States)

    ... first birth and hope to have a vaginal delivery this time, there is a class for that, too. Choose ... t covered in your birthing class, it’s a good idea to take an individual class on it, especially if you are a first-time mother. The health benefits of breastfeeding your baby ...

  1. Feasibility of a Community-Based Sickle Cell Trait Testing and Counseling Program

    Science.gov (United States)

    Housten, Ashley J.; Abel, Regina A.; Lindsey, Terianne; King, Allison A.

    2016-01-01

    Background Sickle cell trait (SCT) screening is required at birth in the United States; however, adults rarely know their SCT status prior to having children. Purpose Assess feasibility of a community-based SCT education and testing intervention. Methods Participants were recruited from eight community sites to complete an educational program and offered a hemoglobin analysis. A genetic counselor met individually with participants to discuss lab results. Results Between July 14, 2010 and May 31, 2012, 637 participants completed the educational program. Five hundred seventy (89.5%) provided a blood sample, and 61 (10.9%) had SCT or other hemoglobinopathies. The genetic counselor met with 321 (56.3%) participants. Conclusions Community-based SCT testing shows initial feasibility and may increase the number of individuals who know their trait status.

  2. Knowledge and Practice of Traditional Birth Attendants (TBAs) in ...

    African Journals Online (AJOL)

    Methods: the study was a cross sectional survey undertaken using structured interviews with TBAs that was ... Key words: Traditional Birth Attendants (TBAS), Skilled Birth Attendants, ..... World Bank, Pathaman I et al eds., Investing in Maternal.

  3. Role of traditional birth attendants in improving reproductive health: lessons from the family health project, Sindh.

    Science.gov (United States)

    Islam, A; Malik, F A

    2001-06-01

    Despite strenuous efforts, the maternal mortality rate in Pakistan remains high. The national figure of 340 maternal deaths per 100,000 live births tends to hide the fact that in some rural areas it is as high as 700 per 100,000 live births. Not surprisingly, in Pakistan only 20% of births are attended by a trained health professional. In most rural areas, home to almost 70% of the population, traditional birth attendants (TBAs) deliver 90% of the births. TBAs, therefore, play a crucial role in the delivery of maternal health care in Pakistan. Realizing the importance of TBAs, the Family Health Project (FHP) of the Department of Health Sindh, financed by the World Bank, tried to enhance their knowledge and skills through comprehensive training programs. FHP provided training to 650 TBAs in 10 districts. The training was provided by the Department of Community Health Sciences (CHS) of the Aga Khan University (AKU) who acted as technical consultant to the project. A community-based qualitative post-intervention survey. Post-intervention survey of this seven-year project (1992-1999) revealed that (a) the training enhanced the knowledge and skills of the TBAs, (b) the trained TBAs provide more broader health care services and (c) they enjoy greater community acceptance and provide greater consumer satisfaction. It also showed that the TBAs remain the most available and accessible health resource in most rural settings. It is imperative that TBAs and their continuing training should remain central to any reproductive health intervention along with an effective referral system linking them to well-equipped emergency obstetric care facilities. However, the assessment clearly demonstrated that an integrated referral system backed by effective emergency obstetric care is essential to the success of the TBA training program.

  4. COMMUNITY BASED HOME ENERGY MANAGEMENT SYSTEM

    Directory of Open Access Journals (Sweden)

    Muhammad Adnan Aziz

    2017-05-01

    Full Text Available In a Smart Grid (SG scenario, domestic consumers can gain cost reduction benefit by scheduling their Appliance Activation Time (AAT towards the slots of low charge. Minimization in cost is essential in Home Energy Management Systems (HEMS to induce consumers acceptance for power scheduling to accommodate for a Demand Response (DR at peak hours. Despite the fact that many algorithms address the power scheduling for HEMS, community based optimization has not been the focus. This paper presents an algorithm that targets the minimization of energy costs of whole community while keeping a low Peak to Average Ratio (PAR and smooth Power Usage Pattern (PUP. Objective of cost reduction is accomplished by finding most favorable AAT by Particle Swarm Optimization (PSO in conjunction with Inclined Block Rate (IBR approach and Circular Price Shift (CPS. Simulated numerical results demonstrate the effectiveness of CPS to assist the merger of PSO & IBR to enhance the reduction/stability of PAR and cost reduction.

  5. Community-based natural resource management

    DEFF Research Database (Denmark)

    Treue, Thorsten; Nathan, Iben

    ) and how this concept may be used as a development strategy. CBNRM has the triple objective of poverty reduction, natural resource conservation and good governance. The opportunity and challenge is to pursue these objectives simultaneously, as they are not, by default, mutually supportive. Lessons learnt...... from CBNRM will be useful when designing community-based climate adaptation strategies. Thus, this note is a contribution to an ongoing debate as well as a product of the long-standing experiences of Danida's environmental portfolio. CBNRM is not a stand-alone solution to secure poverty reduction......, resource conservation and good governance, and whether other resource management systems would be better will always be subject to context analysis and political debate. Accordingly, CBNRM is rather a development process and constant power struggle. Thus, even after years of implementation, donors...

  6. Skilled delivery care service utilization in Ethiopia: analysis of rural ...

    African Journals Online (AJOL)

    Only 10% of women receive assistance from skilled birth attendants either at home or at .... assisted by traditional birth attendants, while 4 % of births were unattended. ..... Dagne E.(2010) Role of socio-demographic factors on utilization of ...

  7. Training Interdisciplinary "Wicked Problem" Solvers: Applying Lessons from HERO in Community-Based Research Experiences for Undergraduates

    Science.gov (United States)

    Cantor, Alida; DeLauer, Verna; Martin, Deborah; Rogan, John

    2015-01-01

    Management of "wicked problems", messy real-world problems that defy resolution, requires thinkers who can transcend disciplinary boundaries, work collaboratively, and handle complexity and obstacles. This paper explores how educators can train undergraduates in these skills through applied community-based research, using the example of…

  8. Missed opportunities for institutional delivery and associated factors among urban resident pregnant women in South Tigray Zone, Ethiopia: a community-based follow-up study

    Directory of Open Access Journals (Sweden)

    Hinsermu Bayu

    2015-09-01

    Full Text Available Background: Every pregnant woman is considered to be at risk and some risks may not always be foreseeable or detectable. Therefore, the presence of a skilled birth attendant at every delivery is considered to be the most critical intervention in reducing maternal mortality and morbidity. In Ethiopia, the proportion of births attended by skilled personnel in urban settings can be as low as 10%. Therefore, the main purpose of this research was to identify factors affecting unplanned home delivery in urban settings, where there is relatively good access in principle to modern healthcare institutions. Design: A community-based follow-up study was conducted from 17 January 2014 to 30 August 2014, among second- and third-trimester pregnant women who had planned for institutional delivery in South Tigray Zone. A systematic sampling technique was used to get a total of 522 study participants. A pre-tested and structured questionnaire was used to collect relevant data. Bivariate and multivariate data analyses were performed using SPSS version 16.0. Results: The study revealed that among 465 pregnant women who planned for institutional delivery, 134 (28.8% opted out and delivered at their home (missed opportunity. Single women (AOR 2.34, 95% CI 1.17–4.68, illiterate mothers (AOR 6.14, 95% CI 2.20–17.2, absence of antenatal clinic visit for indexed pregnancy (AOR 3.11, 95% CI 1.72–5.61, absence of obstetric complications during the index pregnancy (AOR 2.96, 95% CI 1.47–5.97, poor autonomy (AOR 2.11, 95% CI 1.27–3.49, and absence of birth preparedness and complication readiness (AOR 3.83, 95% CI 2.19–6.70 were significant predictors of unplanned home delivery. Conclusions: A significant proportion of pregnant women missed the opportunity of modern delivery assistance. Educational status, antenatal care status, lack of obstetric complications, poor autonomy, and lack of birth preparedness and complication readiness were among the important

  9. Evaluation of a Telerehabilitation System for Community-Based Rehabilitation

    Directory of Open Access Journals (Sweden)

    Jamie L Schutte

    2012-06-01

    Full Text Available The use of web-based portals, while increasing in popularity in the fields of medicine and research, are rarely reported on in community-based rehabilitation programs.  A program within the Pennsylvania Office of Vocational Rehabilitation’s Hiram G. Andrews Center, the Cognitive Skills Enhancement Program (CSEP, sought to enhance organization of program and participant information and communication between part- and full-time employees, supervisors and consultants. A telerehab system was developed consisting of (1 a web-based portal to support a variety of clinical activities and (2 the Versatile Integrated System for Telerehabilitation (VISyTER video-conferencing system to support the collaboration and delivery of rehabilitation services remotely.  This descriptive evaluation examines the usability of the telerehab system incorporating both the portal and VISyTER. Telerehab system users include CSEP staff members from three geographical locations and employed by two institutions. The IBM After-Scenario Questionnaire (ASQ and Post-Study System Usability Questionnaire (PSSUQ, the Telehealth Usability Questionnaire (TUQ, and two demographic surveys were administered to gather both objective and subjective information. Results showed generally high levels of usability.  Users commented that the telerehabilitation system improved communication, increased access to information, improved speed of completing tasks, and had an appealing interface. Areas where users would like to see improvements, including ease of accessing/editing documents and searching for information, are discussed.         

  10. Customizing a rangefinder for community-based wildlife conservation initiatives

    Science.gov (United States)

    Ransom, Jason I.

    2011-01-01

    Population size of many threatened and endangered species is relatively unknown because estimating animal abundance in remote parts of the world, without access to aircraft for surveying vast areas, is a scientific challenge with few proposed solutions. One option is to enlist local community members and train them in data collection for large line transect or point count surveys, but financial and sometimes technological constraints prevent access to the necessary equipment and training for accurately quantifying distance measurements. Such measurements are paramount for generating reliable estimates of animal density. This problem was overcome in a survey of Asiatic wild ass (Equus hemionus) in the Great Gobi B Strictly Protected Area, Mongolia, by converting an inexpensive optical sporting rangefinder into a species-specific rangefinder with visual-based categorical labels. Accuracy trials concluded 96.86% of 350 distance measures matched those from a laser rangefinder. This simple customized optic subsequently allowed for a large group of minimally-trained observers to simultaneously record quantitative measures of distance, despite language, education, and skill differences among the diverse group. The large community-based effort actively engaged local residents in species conservation by including them as the foundation for collecting scientific data.

  11. A Model for Partnering First-Year Student Pharmacists With Community-Based Older Adults

    Science.gov (United States)

    Porter, Andrea L.; Shawl, Lauren; Motl Moroney, Susannah E.

    2012-01-01

    Objectives. To design, integrate, and assess the effectiveness of an introductory pharmacy practice experience intended to redefine first-year student pharmacists’ views on aging and medication use through their work with a healthy, community-based older-adult population. Design. All students (N = 273) completed live skills training in an 8-hour boot camp provided during orientation week. Teams were assigned an independently living senior partner, completed 10 visits and reflections, and documented health-related information using an electronic portfolio (e-portfolio). Assessment. As determined by pre- and post-experience survey instruments, students gained significant confidence in 7 skill areas related to communication, medication interviews, involving the partner in health care, and applying patient-care skills. Student reflections, in-class presentations, and e-portfolios documented that personal attitudes toward seniors changed over time. Senior partners enjoyed mentoring and interacting with students and many experienced health improvements as a result of the interaction. Conclusions. The model for partnering first-year student pharmacists with community-based older adults improved students’ skills and fostered their connections to pharmacist roles and growth as person-centered providers. PMID:22761526

  12. Community-based knowledge transfer and exchange: Helping community-based organizations link research to action

    Directory of Open Access Journals (Sweden)

    Lavis John N

    2010-04-01

    Full Text Available Abstract Background Community-based organizations (CBOs are important stakeholders in health systems and are increasingly called upon to use research evidence to inform their advocacy, program planning, and service delivery efforts. CBOs increasingly turn to community-based research (CBR given its participatory focus and emphasis on linking research to action. In order to further facilitate the use of research evidence by CBOs, we have developed a strategy for community-based knowledge transfer and exchange (KTE that helps CBOs more effectively link research evidence to action. We developed the strategy by: outlining the primary characteristics of CBOs and why they are important stakeholders in health systems; describing the concepts and methods for CBR and for KTE; comparing the efforts of CBR to link research evidence to action to those discussed in the KTE literature; and using the comparison to develop a framework for community-based KTE that builds on both the strengths of CBR and existing KTE frameworks. Discussion We find that CBR is particularly effective at fostering a climate for using research evidence and producing research evidence relevant to CBOs through community participation. However, CBOs are not always as engaged in activities to link research evidence to action on a larger scale or to evaluate these efforts. Therefore, our strategy for community-based KTE focuses on: an expanded model of 'linkage and exchange' (i.e., producers and users of researchers engaging in a process of asking and answering questions together; a greater emphasis on both producing and disseminating systematic reviews that address topics of interest to CBOs; developing a large-scale evidence service consisting of both 'push' efforts and efforts to facilitate 'pull' that highlight actionable messages from community relevant systematic reviews in a user-friendly way; and rigorous evaluations of efforts for linking research evidence to action. Summary

  13. Birth Control Methods

    Science.gov (United States)

    ... Home A-Z Health Topics Birth control methods Birth control methods > A-Z Health Topics Birth control methods ... To receive Publications email updates Enter email Submit Birth control methods Birth control (contraception) is any method, medicine, ...

  14. Facilitators' perceptions of problem-based learning and community-based education

    Directory of Open Access Journals (Sweden)

    Paula P du Rand

    2000-02-01

    Full Text Available In 1997 the School for Nursing, University of the Orange Free State, changed from the traditional lecture method of teaching to problem-based learning and from a curative to a community-based approach. Lecturers from a traditional environment became facilitators and new skills such as listening, dialogue, negotiation, counselling and problemsolving were expected from them. Besides the role change, the environment changed from a structural classroom to an unstructured community. The aim of this research was to determine the perceptions and experiences of facilitators in problem-based learning and community-base education. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  15. Ethical and Professional Norms in Community-Based Research

    Science.gov (United States)

    Campano, Gerald; Ghiso, María Paula; Welch, Bethany J.

    2015-01-01

    In this article Gerald Campano, María Paula Ghiso, and Bethany J. Welch explore the role of ethical and professional norms in community-based research, especially in fostering trust within contexts of cultural diversity, systemic inequity, and power asymmetry. The authors present and describe a set of guidelines for community-based research that…

  16. Assessing Community Based Improved Maternal Neonatal Child Survival (IMNCS) Program in Rural Bangladesh.

    Science.gov (United States)

    Rahman, Mahfuzar; Jhohura, Fatema Tuz; Mistry, Sabuj Kanti; Chowdhury, Tridib Roy; Ishaque, Tanveen; Shah, Rasheduzzaman; Afsana, Kaosar

    2015-01-01

    A community based approach before, during and after child birth has been proven effective address the burden of maternal, neonatal and child morbidity and mortality in the low and middle income countries. We aimed to examine the overall change in maternal and newborn health outcomes due the "Improved Maternal Newborn and Child Survival" (IMNCS) project, which was implemented by BRAC in rural communities of Bangladesh. The intervention was implemented in four districts for duration of 5-years, while two districts served as comparison areas. The intervention was delivered by community health workers who were trained on essential maternal, neonatal and child health care services. A baseline survey was conducted in 2008 among 7, 200 women with pregnancy outcome in last year or having a currently alive child of 12-59 months. A follow-up survey was administered in 2012-13 among 4, 800 women of similar characteristics in the same villages. We observed significant improvements in maternal and essential newborn care in intervention areas over time, especially in health care seeking behaviors. The proportion of births taking place at home declined in the intervention districts from 84.3% at baseline to 71.2% at end line (Pmortality in intervention districts compared to that of comparison districts. This study demonstrates that community-based efforts offer encouraging evidence and value for combining maternal, neonatal and child health care package. This approach might be considered at larger scale in similar settings with limited resources.

  17. A qualitative evaluation of the choice of traditional birth attendants for maternity care in 2008 Sierra Leone: implications for universal skilled attendance at delivery.

    Science.gov (United States)

    Oyerinde, Koyejo; Harding, Yvonne; Amara, Philip; Garbrah-Aidoo, Nana; Kanu, Rugiatu; Oulare, Macoura; Shoo, Rumishael; Daoh, Kizito

    2013-07-01

    Maternal and newborn death is common in Sierra Leone; significant reductions in both maternal and newborn mortality require universal access to a skilled attendant during labor and delivery. When too few women use health facilities MDGs 4 and 5 targets will not be met. Our objectives were to identify why women use services provided by TBAs as compared to health facilities; and to suggest strategies to improve utilization of health facilities for maternity and newborn care services. Qualitative data from focus group discussions in communities adjacent to health facilities collected during the 2008 Emergency Obstetric and Newborn Care Needs Assessment were analyzed for themes relating to decision-making on the utilization of TBAs or health facilities. The prohibitive cost of services, and the geographic inaccessibility of health facilities discouraged women from using them while trust in the vast experience of TBAs as well as their compassionate care drew patients to them. Poor facility infrastructure, often absent staff, and the perception that facilities were poorly stocked and could not provide continuum of care services were barriers to facility utilization for maternity and newborn care. Improvements in infrastructure and the 24-hour provision of free, quality, comprehensive, and respectful care will minimize TBA preference in Sierra Leone.

  18. Evaluation of clinical teaching and professional development in a problem and community-based nursing module

    Directory of Open Access Journals (Sweden)

    J.C de Villiers

    2004-09-01

    Full Text Available In South Africa the main focus is on primary health care. This affects the education and training of nurses, and training schools must respond by developing appropriate teaching modules. A school of nursing developed, implemented and revised a problem- and community- based learning module over a period of three years (1996-1998. This student-centered module focuses on students’ needs, active participation, collaboration, accountability, self-assessment, self-study, life-long learning and appropriate skills. In the formal clinical teaching environment PBL was the main approach. However, this approach was also supported by a variety of strategies, for example group discussions and scenarios. The knowledge, attitudes and professional development skills acquired in the PBL approach were then applied informally in the community setting (CBE. The purpose of the study was to evaluate a first year clinical teaching module as part of an extensive programme. A quantitative research method, a descriptive design, and a variety of data collection techniques were used. Conclusions were that clinical teaching was effective within the problem- (PBL and community-based (CBE approaches; 78% of respondents were positive about the clinical learning environment; 61 % stated that expectations were met; 81% preferred group activities, and 67% indicated that they had developed professional skills. Facilitators agreed that clinical teaching met the requirements of PBL & CBE. The pass rate also improved.

  19. Building a community-based culture of evaluation.

    Science.gov (United States)

    Janzen, Rich; Ochocka, Joanna; Turner, Leanne; Cook, Tabitha; Franklin, Michelle; Deichert, Debbie

    2017-12-01

    In this article we argue for a community-based approach as a means of promoting a culture of evaluation. We do this by linking two bodies of knowledge - the 70-year theoretical tradition of community-based research and the trans-discipline of program evaluation - that are seldom intersected within the evaluation capacity building literature. We use the three hallmarks of a community-based research approach (community-determined; equitable participation; action and change) as a conceptual lens to reflect on a case example of an evaluation capacity building program led by the Ontario Brian Institute. This program involved two community-based groups (Epilepsy Southwestern Ontarioand the South West Alzheimer Society Alliance) who were supported by evaluators from the Centre for Community Based Research to conduct their own internal evaluation. The article provides an overview of a community-based research approach and its link to evaluation. It then describes the featured evaluation capacity building initiative, including reflections by the participating organizations themselves. We end by discussing lessons learned and their implications for future evaluation capacity building. Our main argument is that organizations that strive towards a community-based approach to evaluation are well placed to build and sustain a culture of evaluation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Composing hope through collage: A community-based intervention for cancer survivors living with lymphedema

    Directory of Open Access Journals (Sweden)

    Roanne Thomas

    2016-07-01

    Full Text Available Secondary lymphedema after cancer may result in distress, yet few interventions exist to support coping skills in this population. As part of a community-based intervention, we piloted the use of creative practices to promote active orientations to hope. A total of 19 participants completed the workshops; 11 collaged. The main themes address the collage processes as well as their content. The former addresses sub-themes such as selecting/composing. The latter includes sub-themes related to movement depicted in the collages. Collages and their associated discussions concretized hoping as an active and accessible process for participants living with two chronic illnesses.

  1. Composing hope through collage: A community-based intervention for cancer survivors living with lymphedema

    Directory of Open Access Journals (Sweden)

    Roanne Thomas

    2016-07-01

    Full Text Available Secondary lymphedema after cancer may result in distress, yet few interventions exist to support coping skills in this population. As part of a community-based intervention, we piloted the use of creative practices to promote active orientations to hope. A total of 19 participants completed the workshops; 11 collaged. The main themes address the collage processes as well as their content. The former addresses sub-themes such as selecting/composing. The latter includes sub-themes related to movement depicted in the collages. Collages and their associated discussions concretized hoping as an active and accessible process for participants living with two chronic illnesses.

  2. A community-based organization: the Las Mercedes Project.

    Science.gov (United States)

    Murphy, John W

    2012-01-01

    Using the Las Mercedes Project as an example, the aim of this article is to discuss the philosophy and practice of community-based projects. At the core of such projects is a shift in understanding the nature of community. A community, in this case, represents a reality that persons construct that determines the character of rules, norms, and the focus and style of interventions. Additionally, community-based organizations, such as the Las Mercedes Project, are fully participatory, decentered, and carry the imprint of a community's members. Community-based projects, in this regard, improve the likelihood of creating successful interventions.

  3. Effect on postpartum hemorrhage of prophylactic oxytocin (10 IU by injection by community health officers in Ghana: a community-based, cluster-randomized trial.

    Directory of Open Access Journals (Sweden)

    Cynthia K Stanton

    2013-10-01

    Full Text Available BACKGROUND: Oxytocin (10 IU is the drug of choice for prevention of postpartum hemorrhage (PPH. Its use has generally been restricted to medically trained staff in health facilities. We assessed the effectiveness, safety, and feasibility of PPH prevention using oxytocin injected by peripheral health care providers without midwifery skills at home births. METHODS AND FINDINGS: This community-based, cluster-randomized trial was conducted in four rural districts in Ghana. We randomly allocated 54 community health officers (stratified on district and catchment area distance to a health facility: ≥10 km versus <10 km to intervention (one injection of oxytocin [10 IU] one minute after birth and control (no provision of prophylactic oxytocin arms. Births attended by a community health officer constituted a cluster. Our primary outcome was PPH, using multiple definitions; (PPH-1 blood loss ≥500 mL; (PPH-2 PPH-1 plus women who received early treatment for PPH; and (PPH-3 PPH-2 plus any other women referred to hospital for postpartum bleeding. Unsafe practice is defined as oxytocin use before delivery of the baby. We enrolled 689 and 897 women, respectively, into oxytocin and control arms of the trial from April 2011 to November 2012. In oxytocin and control arms, respectively, PPH-1 rates were 2.6% versus 5.5% (RR: 0.49; 95% CI: 0.27-0.88; PPH-2 rates were 3.8% versus 10.8% (RR: 0.35; 95% CI: 0.18-0.63, and PPH-3 rates were similar to those of PPH-2. Compared to women in control clusters, those in the intervention clusters lost 45.1 mL (17.7-72.6 less blood. There were no cases of oxytocin use before delivery of the baby and no major adverse events requiring notification of the institutional review boards. Limitations include an unblinded trial and imbalanced numbers of participants, favoring controls. CONCLUSION: Maternal health care planners can consider adapting this model to extend the use of oxytocin into peripheral settings including, in some

  4. Preparing for Multiple Births

    Science.gov (United States)

    ... Video Games, and the Internet Preparing for Multiple Births KidsHealth > For Parents > Preparing for Multiple Births Print ... a combination of both. The Risks of Multiple Births The most common risk involved with multiple births ...

  5. Birth environment facilitation by midwives assisting in non-hospital births: a qualitative interview study.

    Science.gov (United States)

    Igarashi, Toshiko; Wakita, Mariko; Miyazaki, Kikuko; Nakayama, Takeo

    2014-07-01

    midwifery homes (similar to birth centres) are rich in midwifery wisdom and skills that differ from those in hospital obstetrical departments, and a certain percentage of pregnant women prefer birth in these settings. This study aimed to understand the organisation of the perinatal environment considered important by independent midwives in non-hospital settings and to clarify the processes involved. semi-structured qualitative interview study and constant comparative analysis. 14 independent midwives assisting at births in midwifery homes in Japan, and six independent midwives assisting at home births. Osaka, Kyoto, Nara, and Shiga, Japan. midwives assisting at non-hospital births organised the birth environment based on the following four categories: 'an environment where the mother and family are autonomous'; 'a physical environment that facilitates birth'; 'an environment that facilitates the movement of the mother for birth'; and 'scrupulous safety preparation'. These, along with their sub-categories, are presented in this paper. independent midwives considered it important to create a candid relationship between the midwife and the woman/family from the period of pregnancy to facilitate birth in which the woman and her family were autonomous. They also organised a distinctive environment for non-hospital birth, with preparations to guarantee safety. Experiential knowledge and skills played a major part in creating an environment to facilitate birth, and the effectiveness of this needs to be investigated objectively in future research. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Developmental Trajectories of Early Communication Skills

    Science.gov (United States)

    Maatta, Sira; Laakso, Marja-Leena; Tolvanen, Asko; Ahonen, Timo; Aro, Tuija

    2012-01-01

    Purpose: This study focused on developmental trajectories of prelinguistic communication skills and their connections to later parent-reported language difficulties. Method: The participants represent a subset of a community-based sample of 508 children. Data include parent reports of prelinguistic communication skills at 12, 15, 18, and 21 months…

  7. Developmental Trajectories of Early Communication Skills

    Science.gov (United States)

    Maatta, Sira; Laakso, Marja-Leena; Tolvanen, Asko; Ahonen, Timo; Aro, Tuija

    2012-01-01

    Purpose: This study focused on developmental trajectories of prelinguistic communication skills and their connections to later parent-reported language difficulties. Method: The participants represent a subset of a community-based sample of 508 children. Data include parent reports of prelinguistic communication skills at 12, 15, 18, and 21 months…

  8. Volume of Home and Community Based Services and...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Volume of Home- and Community-Based Services and Time to Nursing-Home Placement The purpose of this study was to determine whether the volume of Home and Community...

  9. Tribal Community-Based Social Marketing Training Guide

    Science.gov (United States)

    The Community-Based Social Marketing (CBSM) Training Guide and recycling toolkit provides an overview of how to increase the adoption of sustainable behaviors and recycling practices with a community.

  10. Calibration of Community-based Coral Reef Monitoring Protocols ...

    African Journals Online (AJOL)

    Keywords: coral reef monitoring, community-based, calibration. Abstract—Coral reef monitoring (CRM) has been recognised as an important management tool and has ..... Pollution Bulletin 40: 537-550. Wilkinson, C., Green, A., Almany, J. &.

  11. Assessment of socio-economic characteristics of community based ...

    African Journals Online (AJOL)

    Community Based Organizations (CBOs) are voluntary, non-profit, and highly ... The instrument of the study – structured questionnaire - is divided into two ... Keywords: Socio-cultural, Characteristics, Neighbours, Festivals, Community, Nigeria ...

  12. Local natural and cultural heritage assets and community based ...

    African Journals Online (AJOL)

    Local natural and cultural heritage assets and community based tourism: Challenges ... and cultural assets into tourism activities for the benefit of the community. ... all the functions of planning, development, marketing and management of the ...

  13. Community Based Forest Management as a Tool for Sustainable ...

    African Journals Online (AJOL)

    Community-Based Forest Management (CBFM) in Cross River State (CRS) was ... a mutually acceptable formula should be worked out among the stakeholders. ... creation of enabling environment; state economic and fiscal policies, policy to ...

  14. Cocoa farmers'perception of Community Based Nursery Scheme: A ...

    African Journals Online (AJOL)

    Cocoa farmers'perception of Community Based Nursery Scheme: A case study ... Sustainable Tree Crop Programme (STCP)| -Nigeria established Community ... for self improvement of participating farmers (8.3%) and group efforts/ formation ...

  15. Developing community-based intervention strategies to save newborn lives: lessons learned from formative research in five countries.

    Science.gov (United States)

    2008-12-01

    This paper summarizes lessons learned from formative research conducted in Bangladesh, Ghana, India, Mali and Nepal to inform the development of newborn health interventions, mostly in the context of field trials. Current practices, constraints to the adoption of optimal practices and implications for implementing inventions to improve newborn survival are discussed for: optimal care during pregnancy; skilled care at birth; optimal delivery and newborn care practices; special care of low birth weight babies; and timely and appropriate care seeking for newborn illness. General lessons concerning target audiences and intervention strategy are also drawn. In brief, interventions to reduce neonatal mortality need to start during pregnancy not only to promote birth preparedness and institutional delivery, but also to start the process of change concerning early newborn care practices. Their target audience should not only be pregnant or recently delivered women, but also include the main gatekeepers, particularly traditional birth attendants, grandmothers and other family members. Health providers' opinions also matter as care practices are less likely to change if families receive conflicting messages from different sources. Interventions are more likely to succeed if they are not simply message based, but include problem solving approaches, and a behavior change component to address community norms. Although antenatal care (ANC) is theoretically a good channel for newborn interventions, capitalising on its potential is not straightforward, and will require considerable investment and intervention development in its own right in order to improve ANC counselling, which will need to extend beyond training and tackle the many working day constraints encountered by ANC providers. Removing or subsidising the cost of deliveries may be a necessary action to increase institutional deliveries, but it is unlikely to be sufficient; measures will need to be put in place to ensure

  16. The effect of community maternal and newborn health family meetings on type of birth attendant and completeness of maternal and newborn care received during birth and the early postnatal period in rural Ethiopia.

    Science.gov (United States)

    Barry, Danika; Frew, Aynalem Hailemichael; Mohammed, Hajira; Desta, Binyam Fekadu; Tadesse, Lelisse; Aklilu, Yeshiwork; Biadgo, Abera; Buffington, Sandra Tebben; Sibley, Lynn M

    2014-01-01

    Maternal and newborn deaths occur predominantly in low-resource settings. Community-based packages of evidence-based interventions and skilled birth attendance can reduce these deaths. The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) used community-level health workers to conduct prenatal Community Maternal and Newborn Health family meetings to build skills and care-seeking behaviors among pregnant women and family caregivers. Baseline and endline surveys provided data on a random sample of women with a birth in the prior year. An intention-to-treat analysis, plausible net effect calculation, and dose-response analysis examined increases in completeness of care (mean percentage of 17 maternal and newborn health care elements performed) over time and by meeting participation. Regression models assessed the relationship between meeting participation, completeness of care, and use of skilled providers or health extension workers for birth care-controlling for sociodemographic and health service utilization factors. A 151% increase in care completeness occurred from baseline to endline. At endline, women who participated in 2 or more meetings had more complete care than women who participated in fewer than 2 meetings (89% vs 76% of care elements; P < .001). A positive dose-response relationship existed between the number of meetings attended and greater care completeness (P < .001). Women with any antenatal care were nearly 3 times more likely to have used a skilled provider or health extension worker for birth care. Women who had additionally attended 2 or more meetings with family members were over 5 times as likely to have used these providers, compared to women without antenatal care and who attended fewer than 2 meetings (odds ratio, 5.19; 95% confidence interval, 2.88-9.36; P < .001). MaNHEP's family meetings complemented routine antenatal care by engaging women and family caregivers in self-care and care-seeking, resulting in greater completeness

  17. Haemorrhage after home birth: audit of decision making and referral

    NARCIS (Netherlands)

    Smit, M. de; Dijkman, A.; Rijnders, M.; Bustraan, J.; Dillen, J. van; Middeldorp, J.; Havenith, B.; Roosmalen, J. van

    2013-01-01

    In the Netherlands, 20 per cent of women give birth at home. In 0.7 per cent, referral to secondary care because of postpartum haemorrhage (PPH) is indicated. Midwives are regularly trained in managing obstetric emergencies. A postgraduate training programme developed for Dutch community-based midwi

  18. The Importance of Documenting and Including Traditional Wisdom in Community-Based Ecotourism Planning

    Directory of Open Access Journals (Sweden)

    Vesna Đukić

    2017-01-01

    Full Text Available This article accords to the theory of community-based tourism, which represents a concept that respects natural and cultural resources of a particular community and encourages participation of its members in the process of tourist product creation. The article operates in the planning phase and aims to give insights into the process of establishing the groundwork for community-based tourism. The key element is documenting and illustrating everything that could be a part of what is known as “traditional wisdom,” namely, the skills and knowledge of traditional life practices. The methods of case study, content analysis, and observation of the village of Omoljica, Serbia, were used. The positive aspect of this locality is reflected in the existing short-term initiatives of organizations and individuals engaging in preserving traditional practices, but without systematic, long-term planning and management of community-based tourism, these individual efforts to revalue traditional life practices would stay unrecognizable and invisible for visitors and stakeholders. Thus, the main goal of this article is to understand the relation between short-term bottom-up initiatives and long-term top-down strategic planning of specific ecotourism destinations, one that would embrace the traditional ways of rural community life. The contribution of this study, in addition to documenting and illustrating “traditional wisdom” of the specific rural community placed in the protected area which encompasses a particular local social system, will be reflected in the creation of a set of guidelines for sustainable, rural, community-based ecotourism as a soft-driver development of protected areas near big cities of the postsocialist countries.

  19. A systematic review of community-based parenting interventions for adolescents with challenging behaviours.

    Science.gov (United States)

    Medlow, Sharon; Klineberg, Emily; Jarrett, Carmen; Steinbeck, Katharine

    2016-10-01

    Parenting skills training is an established means of treating challenging behaviours among young children, but there has been limited research on its efficacy when used to treat challenging adolescent behaviour. The aim of this systematic review was to evaluate the efficacy and effectiveness of community-based parenting interventions designed for families with adolescents, as judged in terms of increased knowledge and skills among parents, improvements in adolescent behaviour, and program feasibility within community settings. Results indicated that intervention group parents typically made greater gains than did control group parents on measures of good parenting, with positive flow-on effects to some aspects of challenging adolescent behaviours. Limited evidence suggests that group and individual intervention formats may be equally effective and that there is no advantage to the participation of the target adolescent in the intervention. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. All rights reserved.

  20. Perceptions of community-based field workers on the effect of a longitudinal biomedical research project on their sustainable livelihoods.

    Science.gov (United States)

    Moyo, Christabelle S; Francis, Joseph; Bessong, Pascal O

    2017-03-17

    Researchers involved in biomedical community-based projects rarely seek the perspectives of community fieldworkers, who are the 'foot soldiers' in such projects. Understanding the effect of biomedical research on community-based field workers could identify benefits and shortfalls that may be crucial to the success of community-based studies. The present study explored the perceptions of community-based field workers on the effect of the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project" (MAL-ED) South Africa on their tangible and intangible capital which together comprise sustainable livelihoods. The study was conducted in Dzimauli community in Limpopo Province of South Africa between January-February 2016. The sustainable livelihoods framework was used to query community-based field workers' perspectives of both tangible assets such as income and physical assets and intangible assets such as social capital, confidence, and skills. Data were collected through twenty one individual in-depth interviews and one focus group discussion. Data were analysed using the Thematic Content Analysis approach supported by ATLAS.ti, version 7.5.10 software. All the field workers indicated that they benefitted from the MAL-ED South Africa project. The benefits included intangible assets such as acquisition of knowledge and skills, stronger social capital and personal development. Additionally, all indicated that MAL-ED South Africa provided them with the tangible assets of increased income and physical assets. Observations obtained from the focus group discussion and the community-based leaders concurred with the findings from the in-depth interviews. Additionally, some field workers expressed the desire for training in public relations, communication, problem solving and confidence building. The MAL-ED South Africa, biomedical research project, had positive effects on tangible and

  1. An Exploration of Dental Students' Assumptions About Community-Based Clinical Experiences.

    Science.gov (United States)

    Major, Nicole; McQuistan, Michelle R

    2016-03-01

    The aim of this study was to ascertain which assumptions dental students recalled feeling prior to beginning community-based clinical experiences and whether those assumptions were fulfilled or challenged. All fourth-year students at the University of Iowa College of Dentistry & Dental Clinics participate in community-based clinical experiences. At the completion of their rotations, they write a guided reflection paper detailing the assumptions they had prior to beginning their rotations and assessing the accuracy of their assumptions. For this qualitative descriptive study, the 218 papers from three classes (2011-13) were analyzed for common themes. The results showed that the students had a variety of assumptions about their rotations. They were apprehensive about working with challenging patients, performing procedures for which they had minimal experience, and working too slowly. In contrast, they looked forward to improving their clinical and patient management skills and knowledge. Other assumptions involved the site (e.g., the equipment/facility would be outdated; protocols/procedures would be similar to the dental school's). Upon reflection, students reported experiences that both fulfilled and challenged their assumptions. Some continued to feel apprehensive about treating certain patient populations, while others found it easier than anticipated. Students were able to treat multiple patients per day, which led to increased speed and patient management skills. However, some reported challenges with time management. Similarly, students were surprised to discover some clinics were new/updated although some had limited instruments and materials. Based on this study's findings about students' recalled assumptions and reflective experiences, educators should consider assessing and addressing their students' assumptions prior to beginning community-based dental education experiences.

  2. Birth Preparedness and Complication Readiness among Pregnant Women in Duguna Fango District, Wolayta Zone, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Merihun Gebre

    Full Text Available Birth Preparedness and Complication Readiness is a strategy to promote the timely use of skilled maternal and neonatal care, especially during childbirth, based on the theory that preparing for childbirth and being ready for complications reduces delays in obtaining this care.This study was conducted to assess birth preparedness and complication readiness and its associated factors among pregnant woman in Duguna Fango District in Wolayta Zone, South Ethiopia.A community based cross-sectional study was conducted in 2013, on a sample of 578 pregnant women. Data were collected using pre-tested and structured questionnaire. The collected data were analyzed by SPSS for windows version 16.0. The women were asked whether they followed the desired five steps while pregnant: identified a trained birth attendant, identified a health facility, arranged for transport, identified blood donor and saved money for emergency. Taking at least three steps was considered being well-prepared.Among 578 pregnant women only one tenth (10.7% of pregnant women identified skilled provider. Only 103 (18.1% arranged transportation to health facility. Two hundred forty eight (43.6% identified health facility for delivery and/or for obstetric emergencies. more than half (54.1% of families saved money for incurred costs of delivery and emergency if needed. only few 17(3% identified potential blood donor in case of emergency. Two hundred sixty four (46.4% of the respondents reported that they intended to deliver at home, and more than half (53.6 planned to deliver at health facilities. Overall less than one fifth 18.3% of pregnant women were well prepared. The adjusted multivariate model showed that significant predictors for being well-prepared were maternal availing of antenatal services (AOR = 2.95, 95% CI: 1.62-5.37, being pregnant for the first time (AOR = 3.37, 95% CI: 1.45-7.82, having knowledge of at least two danger signs during pregnancy (AOR = 2.81, 95% CI: 1

  3. Birth Preparedness and Complication Readiness among Pregnant Women in Duguna Fango District, Wolayta Zone, Ethiopia.

    Science.gov (United States)

    Gebre, Merihun; Gebremariam, Abebe; Abebe, Tsedach Alemu

    2015-01-01

    Birth Preparedness and Complication Readiness is a strategy to promote the timely use of skilled maternal and neonatal care, especially during childbirth, based on the theory that preparing for childbirth and being ready for complications reduces delays in obtaining this care. This study was conducted to assess birth preparedness and complication readiness and its associated factors among pregnant woman in Duguna Fango District in Wolayta Zone, South Ethiopia. A community based cross-sectional study was conducted in 2013, on a sample of 578 pregnant women. Data were collected using pre-tested and structured questionnaire. The collected data were analyzed by SPSS for windows version 16.0. The women were asked whether they followed the desired five steps while pregnant: identified a trained birth attendant, identified a health facility, arranged for transport, identified blood donor and saved money for emergency. Taking at least three steps was considered being well-prepared. Among 578 pregnant women only one tenth (10.7%) of pregnant women identified skilled provider. Only 103 (18.1%) arranged transportation to health facility. Two hundred forty eight (43.6%) identified health facility for delivery and/or for obstetric emergencies. more than half (54.1%) of families saved money for incurred costs of delivery and emergency if needed. only few 17(3%) identified potential blood donor in case of emergency. Two hundred sixty four (46.4%) of the respondents reported that they intended to deliver at home, and more than half (53.6) planned to deliver at health facilities. Overall less than one fifth 18.3% of pregnant women were well prepared. The adjusted multivariate model showed that significant predictors for being well-prepared were maternal availing of antenatal services (AOR = 2.95, 95% CI: 1.62-5.37), being pregnant for the first time (AOR = 3.37, 95% CI: 1.45-7.82), having knowledge of at least two danger signs during pregnancy (AOR = 2.81, 95% CI: 1.69-4.67) and

  4. Community based clinical program: the Medunsa physiotherapy students` experience

    Directory of Open Access Journals (Sweden)

    N. P. Taukobong

    2004-02-01

    Full Text Available Backgound: The aim of community based clinical training is tproduce graduates who are responsive to the health needs of their communit It is envisaged that upon completion of training graduates would go back an serve their respective communities following exposure to community need Program evaluation should therefore allow students to express the inadequacie and strengths of the program.Aim: To evaluate the community-based clinical program through student's experiences.Methodology: A qualitative research design was used. End of block students reports for both third (8 and fourth (15 year physiotherapy students (n = 23 were used to collect the data. Responses in the reports were grouped into the following categories for purpose of data analysis: feeling about the block, suggestion/s and supervision.Results: The students described the community based clinical program as an unique learning experience which equipped them with the understanding of life within communities. Sixty five percent (65% expressed satisfaction with the supervision given. The main complaints were amounts of paper work involved and clinical workload.Conclusion: The student's experiences indicated that the community-based clinical program within the MEDUNSA physiotherapy department realizes the goal of community-based clinical training as determined by WHO, except for inclusion of some multi-professional approaches and adaptation of the supervision provided.

  5. Birth cohorts

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Madsen, Mia

    2009-01-01

    ; provides practical guidance on how to set-up and maintain birth cohorts for completing family-based studies in life course epidemiology; describes how to undertake appropriate statistical analyses of family-based studies and correctly interpret results from these analyses; and provides examples...... that illustrate the ways in which family-based studies can enhance our understanding of life course epidemiology. In addition, there is discussion of difficulties specific to setting up such studies in low- and middle-income countries, and issues relating to proxy informants, where parents provide information...... on children and vice versa, or siblings provide information about each other. Examples of how family-based studies have been used in understanding the life course epidemiology of cardiovascular disease, mental health, and reproductive health illustrate the applicability of the research to these areas...

  6. Perinatal mortality in eastern Uganda: a community based prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Victoria Nankabirwa

    Full Text Available BACKGROUND: To achieve a child mortality reduction according to millennium development goal 4, it is necessary to considerably reduce neonatal mortality. We report stillbirth and early neonatal mortality risks as well as determinants of perinatal mortality in Eastern Uganda. METHODS: A community-based prospective cohort study was conducted between 2006 and 2008. A total of 835 pregnant women were followed up for pregnancy outcome and survival of their children until 7 days after delivery. Mother's residence, age, parity, bed net use and whether delivery took place at home were included in multivariable regression analyses to identify risk factors for perinatal death. RESULTS: The stillbirth risk was 19 per 1,000 pregnancies and the early neonatal death risk 22 per 1,000 live births. Overall, the perinatal mortality risk was 41 [95%CI: 27, 54] per 1,000 pregnancies. Of the deaths, 47% followed complicated deliveries and 24% preterm births. Perinatal mortality was 63/1,000 pregnancies among teenage mothers, 76/1,000 pregnancies among nulliparous women and 61/1,000 pregnancies among women delivering at home who, after controlling for potential confounders, had a 3.7 (95%CI: 1.8, 7.4 times higher perinatal mortality than women who gave birth in a health facility. This association was considerably stronger among nulliparous women [RR 8.0 (95%CI: 2.9, 21.6] than among women with a previous live birth [RR 1.8 (95%CI: 0.7, 4.5]. All perinatal deaths occurred among women who did not sleep under a mosquito net. Women living in urban slums had a higher risk of losing their babies than those in rural areas [RR: 2.7 (95%CI: 1.4, 5.3]. CONCLUSION: Our findings strengthen arguments for ensuring that pregnant women have access to and use adequate delivery facilities and bed nets.

  7. Institutional Delivery Service Utilization among Women from Rural Districts of Wolaita and Dawro Zones, Southern Ethiopia; a Community Based Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Mihiretu Alemayehu Arba

    Full Text Available The highest number of maternal deaths occur during labour, delivery and the first day after delivery highlighting the critical need for good quality care during this period. Therefore, for the strategies of institutional delivery to be effective, it is essential to understand the factors that influence individual and household factors to utilize skilled birth attendance and institutions for delivery. This study was aimed to assess factors affecting the utilization of institutional delivery service of women in rural districts of Wolaita and Dawro Zones.A community based cross-sectional study was done among mothers who gave birth within the past one year preceding the survey in Wolaita and Dawro Zones, from February 01 -April 30, 2015 by using a three stage sampling technique. Initially, 6 districts were selected randomly from the total of 17 eligible districts. Then, 2 kebele from each district was selected randomly cumulating a total of 12 clusters. Finally, study participants were selected from each cluster by using systematic sampling technique. Accordingly, 957 mothers were included in the survey. Data was collected by using a pretested interviewer administered structured questionnaire. The questionnaire was prepared by including socio-demographic variables and variables of maternal health service utilization factors. Data was entered using Epi-data version 1.4.4.0 and exported to SPSS version 20 for analysis. Bivariate and multiple logistic regressions were applied to identify candidate and predictor variables respectively.Only 38% of study participants delivered the index child at health facility. Husband's educational status, wealth index, average distance from nearest health facility, wanted pregnancy, agreement to follow post-natal care, problem faced during delivery, birth order, preference of health professional for ante-natal care and maternity care were predictors of institutional delivery.The use of institutional delivery service is

  8. Community-Based Research (CBR in the Education Doctorate: Lessons Learned and Promising Practices

    Directory of Open Access Journals (Sweden)

    Laurie Stevahn

    2016-12-01

    Full Text Available Community-based research (CBR is an advanced form of academic service-learning through which university students, faculty, and community organizations collaborate to conduct inquiry projects aimed at producing social change. Despite its potential for advancing learning in graduate studies, little research exists on CBR implementations or outcomes in doctoral programs. This study examined the effectiveness of integrating CBR into an educational leadership doctorate across three consecutive cohorts in which students worked in teams to conduct CBR projects, each in partnership with a community organization pursuing a social justice initiative. A mixed-methods developmental case study design produced quantitative and qualitative data on students’ perceived effectiveness of cooperative/collaborative interaction and team decision making in CBR, experience with and learning from CBR in the education doctorate, and development of CBR competencies. Triangulated results overall revealed students’ (a positive attitudes toward CBR, (b enhanced understanding of and commitment to CBR and how to conduct it, (c expanded understanding and application of technical research skills, (d growth in coopera-tive/collaborative and conflict resolution skills, and (e development of leadership project management skills. These findings may assist faculty in planning innovative, authentic, applied, professional training in the education doctorate capable of advancing students’ graduate inquiry skills while also enhancing competencies for successful leadership in the field.

  9. ROLES OF TRADITIONAL BIRTH ATTENDANTS AND PERCEPTIONS ON THE POLICY DISCOURAGING HOME DELIVERY IN COASTAL KENYA.

    Science.gov (United States)

    Wanyua, S; Kaneko, S; Karama, M; Makokha, A; Ndemwa, M; Kisule, A; Changoma, M; Goto, K; Shimada, M

    2014-03-01

    To describe the roles of Traditional Birth Attendants (TBAs), to determine the perceptions of TBAs and Skilled Birth Attendants (SBAs) towards the policy discouraging home delivery by TBAs and to establish the working relationship between TBAs and SBAs in Kwale, Kenya. Community based cross-sectional study. Mwaluphamba, Kinango and Golini locations of Kwale County, Kenya. Fifty eight participants were involved in the study. Interviews were conducted with 22 TBAs and 8 SBAs as well as 3 FGDs with 28 TBAs were carried out in July 2012. Roles of TBAs, policy awareness and support as well as the working relationship between TBAs and SBAs. Before delivery, the main role of TBAs was checking position of the baby in the womb (86%) while during delivery, the main role was stomach massage (64%). However, majority (95%) of the TBAs did not provide any after delivery. All SBAs and 59% of TBAs were aware of the policy while 88% SBAs and 36% of TBAs supported it. The working relationship between TBAs and SBAs mainly involved the referral of women to health facilities (HFs). Sometimes, TBAs accompanied women to the HF offering emotional support until after delivery. TBAs in Kwale have a big role to play especially during pregnancy and delivery periods. Awareness and support of the policy as well as the collaboration between SBAs and TBAs should be enhanced in Kwale.

  10. Birth Control Explorer

    Science.gov (United States)

    ... STIs Media Facebook Twitter Tumblr Shares · 467 Birth Control Explorer Sort by all methods most effective methods ... You are here Home » Birth Control Explorer Birth Control Explorer If you’re having sex —or if ...

  11. Birth control pills - combination

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000655.htm Birth control pills - combination To use the sharing features on ... both progestin and estrogen. What Are Combination Birth Control Pills? Birth control pills help keep you from ...

  12. Essure Permanent Birth Control

    Science.gov (United States)

    ... Prosthetics Essure Permanent Birth Control Essure Permanent Birth Control Share Tweet Linkedin Pin it More sharing options ... System Essure is a a permanently implanted birth control device for women (female sterilization). Implantation of Essure ...

  13. CDC WONDER: Births

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Births (Natality) online databases in CDC WONDER report birth rates, fertility rates and counts of live births occurring within the United States to U.S....

  14. Facts about Birth Defects

    Science.gov (United States)

    ... Button Information For… Media Policy Makers Facts about Birth Defects Language: English (US) Español (Spanish) Recommend ... having a baby born without a birth defect. Birth Defects Are Common Every 4 ½ minutes, a ...

  15. CDC WONDER: Births

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Births (Natality) online databases in CDC WONDER report birth rates, fertility rates and counts of live births occurring within the United States to U.S....

  16. Birth Defects: Cerebral Palsy

    Science.gov (United States)

    ... defects, premature birth and infant mortality. Solving premature birth Featured articles Accomplishments and lessons learned since the ... and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce your ...

  17. Warning Signs After Birth

    Science.gov (United States)

    ... defects, premature birth and infant mortality. Solving premature birth Featured articles Accomplishments and lessons learned since the ... and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how to help reduce your ...

  18. Extremely Preterm Birth

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Extremely Preterm Birth Home For Patients Search FAQs Extremely Preterm Birth ... Spanish FAQ173, June 2016 PDF Format Extremely Preterm Birth Pregnancy When is a baby considered “preterm” or “ ...

  19. Community-Based Social Marketing: Involvement in Health Programs.

    Science.gov (United States)

    Farmer, Frank L.; Clarke, Leslie L.; Flocks, Joan D.; Bryant, Carol A.; Romund, Camilla S.; Albrecht, Stan L.

    2002-01-01

    Two community-based projects employed social marketing to design and implement interventions to promote health. The Arkansas project involved key informant interviews, actuarial analysis, citizen and student surveys, and participant observation. The Florida approach included focus groups and provider, worker, and employer surveys. (Contains 25…

  20. Evaluation of a Community-Based Aging Intervention Program

    Science.gov (United States)

    Hsu, Hui-Chuan; Wang, Chun-Hou; Chen, Yi-Chun; Chang, Ming-Chen; Wang, Jean

    2010-01-01

    This study evaluated the outcome and process of a community-based aging intervention program for the elderly in Taiwan. The program included education on nutrition and dietary behavior and on physical activities. Outcome and process evaluations were conducted. The program may have had some effects on decreasing some dietary behavioral problems and…

  1. Three Initiatives for Community-Based Art Education Practices

    Science.gov (United States)

    Lim, Maria; Chang, EunJung; Song, Borim

    2013-01-01

    Art educators should be concerned with teaching their students to make critical connections between the classroom and the outside world. One effective way to make these critical connections is to provide students with the opportunity to engage in community-based art endeavors. In this article, three university art educators discuss engaging…

  2. Community-Based Learning: Practices, Challenges, and Reflections

    Science.gov (United States)

    Morton, Mavis

    2009-01-01

    This paper will highlight an innovate practice in teaching and learning by reflecting on two fourth-year sociology seminar classes that participated in a community-based learning project at York University. Fifty students collaborated in three to six person teams to work on a problem/issue identified by one of five not-for-profit organizations who…

  3. The freedom to choose: integrating community- based reproductive ...

    African Journals Online (AJOL)

    approach to community-based conservation and development that reflects the ... Indian Ocean e-Ink. Promoting African ... People living in isolated communities in rural Atsimo-Andrefana have to travel up to ... challenges of unmet reproductive health needs, food insecurity, .... Frequent radio broadcasts featuring songs and ...

  4. Beyond the Four Walls: Community-Based Learning and Languages

    Science.gov (United States)

    O'Connor, Anne

    2012-01-01

    At a time when languages in universities are under pressure, community-based learning language courses can have many positive benefits: they can increase interest in language learning, they can foster greater engagement with learning, and they can encourage active learning, creativity and teamwork. These courses, which link the classroom and the…

  5. The Importance of Infrastructure for Support for Community Based Learning

    Science.gov (United States)

    Rosenberg, Helen; Karp, Debra

    2012-01-01

    The Community Based Learning (CBL) Certificate and the Civic Honors Program provide unique opportunities for students to receive college credit for their civic participation. The authors describe these programs and the historical and administrative changes at the University of Wisconsin-Parkside, which created an environment for their development…

  6. An Honors Interdisciplinary Community-Based Research Course

    Science.gov (United States)

    Dunbar, David; Terlecki, Melissa; Watterson, Nancy; Ratmansky, Lisa

    2013-01-01

    This article describes how two faculty members at Cabrini College--one from biology and the other from psychology--incorporated interdisciplinary community-based research in an honors course on environmental watershed issues. The course, Environmental Psychology, was team-taught in partnership with a local watershed organization, the Valley Creek…

  7. Negotiation of values as driver in community-based PD

    DEFF Research Database (Denmark)

    Gronvall, Erik; Malmborg, Lone; Messeter, Jörn

    2016-01-01

    and design things; and different accounts of values in design. Inspired by the concept of design things, and as a consequence of the need for continuous negotiation of values observed in all three cases, we suggest the concept of thinging as fruitful for creating productive agonistic spaces with a stronger...... attention towards the process of negotiating values in community-based PD....

  8. Community-Based Solid Waste Management: A Training Facilitator's Guide.

    Science.gov (United States)

    Peace Corps, Washington, DC. Information Collection and Exchange Div.

    Urban environmental management and environmental health issues are of increasing concern worldwide. The need for urban environmental management work at the local level where the Peace Corps works most effectively is significant, but training materials dedicated specifically to community-based solid waste management work in urban areas are lacking.…

  9. Establishing common ground in community-based arts in health.

    Science.gov (United States)

    White, Mike

    2006-05-01

    This article originates in current research into community-based arts in health. Arts in health is now a diverse field of practice, and community-based arts in health interventions have extended the work beyond healthcare settings into public health. Examples of this work can now be found internationally in different health systems and cultural contexts. The paper argues that researchers need to understand the processes through which community-based arts in health projects evolve, and how they work holistically in their attempt to produce therapeutic and social benefits for both individuals and communities, and to connect with a cultural base in healthcare services themselves. A development model that might be adapted to assist in analysing this is the World Health Organisation Quality of Life Index (WHOQOL). Issues raised in the paper around community engagement, healthy choice and self-esteem are then illustrated in case examples of community-based arts in health practice in South Africa and England; namely the DramAide and Siyazama projects in KwaZulu-Natal, and Looking Well Healthy Living Centre in North Yorkshire. In South Africa there are arts and media projects attempting to raise awareness about HIV/AIDS through mass messaging, but they also recognize that they lack models of longer-term community engagement. Looking Well by contrast addresses health issues identified by the community itself in ways that are personal, empathic and domesticated. But there are also similarities among these projects in their aims to generate a range of social, educational and economic benefits within a community-health framework, and they are successfully regenerating traditional cultural forms to create public participation in health promotion. Process evaluation may provide a framework in which community-based arts in health projects, especially if they are networked together to share practice and thinking, can assess their ability to address health inequalities and focus

  10. Integrating community based disaster risk reduction and climate change adaptation: examples from the Pacific

    Directory of Open Access Journals (Sweden)

    A. Gero

    2011-01-01

    Full Text Available It is acknowledged by academics and development practitioners alike that many common strategies addressing community based disaster risk reduction and climate change adaptation duplicate each other. Thus, there is a strong push to integrate the two fields to enhance aid effectiveness and reduce confusion for communities. Examples of community based disaster risk reduction (DRR and climate change adaptation (CCA projects are presented to highlight some of the ways these issues are tackled in the Pacific. Various approaches are employed but all aim to reduce the vulnerability and enhance the resilience of local communities to the impacts of climate change and disasters. By focusing on three case studies, elements of best practice are drawn out to illustrate how DRR and CCA can be integrated for enhanced aid effectiveness, and also look at ways in which these two often overlapping fields can be better coordinated in ongoing and future projects. Projects that address vulnerability holistically, and target the overall needs and capacity of the community are found to be effective in enhancing the resilience of communities. By strategically developing a multi-stakeholder and multi-sector approach, community projects are likely to encapsulate a range of experience and skills that will benefit the community. Furthermore, by incorporating local knowledge, communities are far more likely to be engaged and actively participate in the project. From selected case studies, commonly occurring best practice methods to integrate DRR and CCA are identified and discussed and recommendations on how to overcome the common challenges also presented.

  11. CARDIOLOGY CLINICAL TRIAL PARTICIPATION IN COMMUNITY-BASED HEALTHCARE SYSTEMS: OBSTACLES AND OPPORTUNITIES

    Science.gov (United States)

    Somkin, Carol P.; Altschuler, Andrea; Ackerson, Lynn; Tolsma, Dennis; Rolnick, Sharon J.; Yood, Robert; Weaver, W. Douglas; Von Worley, Ann; Hornbrook, Mark; Magid, David J.; Go, Alan S.

    2008-01-01

    Background The objective of our study was to examine cardiologists’ and organizational leaders’ interest in clinical trial participation and perceived barriers and facilitators to participation within ten diverse non-profit healthcare delivery systems. Trials play a pivotal role in advancing knowledge about the safety and efficacy of cardiovascular interventions and tests. Although cardiovascular trials successfully enroll patients, recruitment challenges persist. Community-based health systems could be an important source of participants and investigators, but little is known about community cardiologists’ experiences with trials. Methods We interviewed 25 cardiology and administrative leaders and mailed questionnaires to all 280 cardiologists at 10 U.S. healthcare organizations. Results The survey received a 73% response rate. While 60% of respondents had not participated in any trials in the past year, nearly 75% wanted greater participation. Cardiologists reported positive attitudes toward trial participation; more than half agreed that trials were their first choice of therapy for patients, if available. Almost all leaders described their organizations as valuing research but not necessarily trials. Major barriers to participation were lack of physician time and insufficient skilled research nurses. Conclusions Cardiologists have considerable interest in trial participation. Major obstacles to increased participation are lack of time and effective infrastructure to support trials. These results suggest that community-based health systems are a rich source for cardiovascular research but additional funding and infrastructure are needed to leverage this resource. PMID:18397842

  12. An Evaluation of Community-Based Action Research Program for Medical Undergraduates in Rural Pondicherry

    Directory of Open Access Journals (Sweden)

    Murugan V

    2013-11-01

    Full Text Available Objective: To obtain the learners’ reaction to a community-based action research program in a rural setting of Pondicherry. Methods: Both quantitative (post-then-pre rating and qualitative (response to open ended questions feedback from 125 medical students exposed to this program was obtained. Mean values were calculated for pre and post self-rating on skills acquired by the students in retro-pre feedback. The content analysis of the qualitative data was undertaken. Results: There was significant improvement in their perceived abilities to follow basic steps in carrying out research such as – problem identification, literature search, drafting a proposal, preparation of questionnaire, data collection, analysis and its reporting. Our approach could contribute to development of cognitive, social-emotional and vocational domains of the students. Conclusions: Overall, our community-based action research program is taking a shape and getting mainstreamed in the exiting curriculum. It could sensitize students to basic steps in research and contributed to their cognitive, social-emotional and vocational development. Further work is needed to increase its scope and intensity to achieve the development of cultural, moral and ethical domains.

  13. Integrating community based disaster risk reduction and climate change adaptation: examples from the Pacific

    Science.gov (United States)

    Gero, A.; Méheux, K.; Dominey-Howes, D.

    2011-01-01

    It is acknowledged by academics and development practitioners alike that many common strategies addressing community based disaster risk reduction and climate change adaptation duplicate each other. Thus, there is a strong push to integrate the two fields to enhance aid effectiveness and reduce confusion for communities. Examples of community based disaster risk reduction (DRR) and climate change adaptation (CCA) projects are presented to highlight some of the ways these issues are tackled in the Pacific. Various approaches are employed but all aim to reduce the vulnerability and enhance the resilience of local communities to the impacts of climate change and disasters. By focusing on three case studies, elements of best practice are drawn out to illustrate how DRR and CCA can be integrated for enhanced aid effectiveness, and also look at ways in which these two often overlapping fields can be better coordinated in ongoing and future projects. Projects that address vulnerability holistically, and target the overall needs and capacity of the community are found to be effective in enhancing the resilience of communities. By strategically developing a multi-stakeholder and multi-sector approach, community projects are likely to encapsulate a range of experience and skills that will benefit the community. Furthermore, by incorporating local knowledge, communities are far more likely to be engaged and actively participate in the project. From selected case studies, commonly occurring best practice methods to integrate DRR and CCA are identified and discussed and recommendations on how to overcome the common challenges also presented.

  14. Community-based medical education: is success a result of meaningful personal learning experiences?

    Science.gov (United States)

    Kelly, Len; Walters, Lucie; Rosenthal, David

    2014-01-01

    Community-based medical education (CBME) is the delivery of medical education in a specific social context. Learners become a part of social and medical communities where their learning occurs. Longitudinal integrated clerkships (LICs) are year-long community-based placements where the curriculum and clinical experience is typically delivered by primary care physicians. These programs have proven to be robust learning environments, where learners develop strong communication skills and excellent clinical reasoning. To date, no learning model has been offered to describe CBME. The characteristics of CBME are explored by the authors who suggest that the social and professional context provided in small communities enhances medical education. The authors postulate that meaningfulness is engendered by the authentic context, which develops over time. These relationships with preceptors, patients and the community provide meaningfulness, which in turn enhances learning. The authors develop a novel learning model. They propose that the context-rich environment of CBME allows for meaningful relationships and experiences for students and that such meaningfulness enhances learning.

  15. Empowering Promotores de Salud to engage in Community-Based Participatory Research.

    Science.gov (United States)

    Cupertino, A Paula; Suarez, Natalia; Cox, Lisa Sanderson; Fernández, Cielo; Jaramillo, Mary Lou; Morgan, Aura; Garrett, Susan; Mendoza, Irazema; Ellerbeck, Edward F

    2013-01-01

    Latino immigrants are less likely to be involved in addressing health-related issues affecting their own community. Community health workers have played a significant role in addressing the health of underserved communities in several countries. The objective of this article is to describe the development, implementation and evaluation of a community-based training program that empowers promotores to identify the health needs of recent Latino immigrants. Promotores were able to develop interventions based on the needs of recent Latino immigrants. Latino community members participated in a 30-hour training program. Training was provided in 15 two-hour sessions over 3 months. Training included field work accompanied by skills development in leadership, organization, interpersonal communication, and survey implementation. Upon completion of the training, promotores conducted household surveys designed to identify community health needs. The evaluation employed quantitative measures to track promotores' canvassing activities and assessment of health behaviors. Out of the 22 promotores enrolled in the training program, 15 (68.18%) completed the training program. Within 3 months, promotores administered 105 household surveys and identified poor access to health care, lack of insurance (78.6%), low daily consumption of fruits (73%) and vegetables (37.5%) and frequent exposure to tobacco smoke (31.7%). Our study demonstrated the feasibility of recruiting and engaging promotores to identify health priorities within the Latino community. This initial step will inform the development of future community-based interventions.

  16. The Human Resources Challenge to Community Based Rehabilitation: The Need for a Scientific, Systematic and Coordinated Global Response

    Directory of Open Access Journals (Sweden)

    Eilish McAuliffe

    2013-02-01

    Full Text Available The World Report on Disability highlights some of the major challenges in the path to realisation of the rights of persons with disabilities as per the United Nations Convention. While the recently published guidelines on Community Based Rehabilitation show the way to address these challenges, effective implementation would require not only higher levels of investment in human resources, but also a significantly newer and different skill-set for the additional personnel.  The authors suggest that a scientifically sophisticated, systematic and coordinated research programme, with global reach and participation, is needed for the establishment of a useful and robust evidence-base for Community Based Rehabilitation interventions. It is also suggested that the development of a new cadre of rehabilitation workers could be a key component of the programme, and could help to alleviate the extant crisis in human resources for health in many low-income countries.

  17. Preparing new nurse graduates for practice in multiple settings: a community-based academic-practice partnership model.

    Science.gov (United States)

    West, Nikki; Berman, Audrey; Karshmer, Judith; Prion, Susan; Van, Paulina; Wallace, Jonalyn

    2014-06-01

    Responding to local and national concerns about the nursing workforce, the California Institute for Nursing and Health Care worked with private and public funders and community health care partners to establish community-based transition-to-practice programs for new RN graduates unable to secure nursing positions in the San Francisco Bay Area. The goals were to retain new RN graduates in nursing and further develop their skills and competencies to increase their employability. Leaders from academic and inpatient, ambulatory, and community-based practice settings, as well as additional community partners, collaboratively provided four 12- to 16-week pilot transition programs in 2010-2011. A total of 345 unemployed new nurse graduates enrolled. Eighty-four percent of 188 respondents to a post-program survey were employed in inpatient and community settings 3 months after completion. Participants and clinical preceptors also reported increases in confidence and competence.

  18. A Pleasing Birth

    NARCIS (Netherlands)

    Vries, De Raymond

    2005-01-01

    Women have long searched for a pleasing birth-a birth with a minimum of fear and pain, in the company of supportive family, friends, and caregivers, a birth that ends with a healthy mother and baby gazing into each other's eyes. For women in the Netherlands, such a birth is defined as one at home un

  19. A community-based participatory planning process and multilevel intervention design: toward eliminating cardiovascular health inequities.

    Science.gov (United States)

    Schulz, Amy J; Israel, Barbara A; Coombe, Chris M; Gaines, Causandra; Reyes, Angela G; Rowe, Zachary; Sand, Sharon L; Strong, Larkin L; Weir, Sheryl

    2011-11-01

    The elimination of persistent health inequities requires the engagement of multiple perspectives, resources, and skills. Community-based participatory research (CBPR) is one approach to developing action strategies that promote health equity by addressing contextual as well as individual-level factors, and that can contribute to addressing more fundamental factors linked to health inequity. Yet many questions remain about how to implement participatory processes that engage local insights and expertise, are informed by the existing public health knowledge base, and build support across multiple sectors to implement solutions. This article describes a CBPR approach used to conduct a community assessment and action planning process, culminating in development of a multilevel intervention to address inequalities in cardiovascular disease in Detroit, Michigan. The authors consider implications for future efforts to engage communities in developing strategies toward eliminating health inequities.

  20. Financial impact of community-based dental education.

    Science.gov (United States)

    Bailit, Howard L

    2010-10-01

    The financial impact of community-based dental education on dental school and community clinic budgets is a major issue. The evidence suggests that community experiences for dental students of fifty or more days, if effectively managed, can increase school net revenues due to the following factors: 1) the community rotations increase student productivity, approximating the loss of dental school clinical income; 2) the reallocation of unused clinical resources at the dental school reduces student clinic deficits; 3) schools and federally qualified health centers (FQHCs) that share surplus student patient revenues generate additional net income; and 4) enrollment of more students without additional new facilities and faculty increases total school tuition revenues. For FQHC dental clinics, student rotations increase the number of patients treated and may generate surplus revenues. Community-based dental education also provides schools and clinics important non-financial advantages.

  1. Fostering sustainable behavior through community-based social marketing.

    Science.gov (United States)

    McKenzie-Mohr, D

    2000-05-01

    Psychology has a central role to play in speeding the transition to a sustainable future, because a central aspect of sustainability is widespread behavior change. To date, however, most programs promoting sustainable behavior have featured information-intensive campaigns that make little use of psychological knowledge. Community-based social marketing is an attractive alternative approach in which promoters identify the activity to be promoted and the barriers to this activity and then design a strategy to overcome these barriers, using psychological knowledge regarding behavior change. The strategy is piloted to test its effectiveness and later evaluated when it is implemented on a broader scale. Unlike many information-intensive campaigns, community-based social marketing has been shown to have a much greater probability of promoting sustainable behavior. Two case studies are provided to illustrate the approach and its possible results.

  2. Evaluation of the integrated community based home care model

    Directory of Open Access Journals (Sweden)

    LR Uys

    2001-09-01

    Full Text Available In 1999-2000 the Integrated Community-Based Home Care model for the care of people with AIDS in communities were implemented in seven sites across the country. The post-implementation evaluation showed that most respondents felt that the model could be replicated if a functioning and informed network including all partners, and a strong management team were in place. The effects of the project were mainly positive for all stakeholders (hospice, clinic, hospital, PWA and their carers, professionals and other community members. Hospitals and community- based services became more aware of and involved in the needs of PWA and felt that the model enabled them to address these needs. PWA and their carers felt supported and respected.

  3. A collaborative model for supporting community-based interdisciplinary education.

    Science.gov (United States)

    Carney, Patricia A; Schifferdecker, Karen E; Pipas, Catherine F; Fall, Leslie H; Poor, Daniel A; Peltier, Deborah A; Nierenberg, David W; Brooks, W Blair

    2002-07-01

    Development and support of community-based, interdisciplinary ambulatory medical education has achieved high priority due to on-site capacity and the unique educational experiences community sites contribute to the educational program. The authors describe the collaborative model their school developed and implemented in 2000 to integrate institution- and community-based interdisciplinary education through a centralized office, the strengths and challenges faced in applying it, the educational outcomes that are being tracked to evaluate its effectiveness, and estimates of funds needed to ensure its success. Core funding of $180,000 is available annually for a centralized office, the keystone of the model described here. With this funding, the office has (1) addressed recruitment, retention, and quality of educators for UME; (2) promoted innovation in education, evaluation, and research; (3) supported development of a comprehensive curriculum for medical school education; and (4) monitored the effectiveness of community-based education programs by tracking product yield and cost estimates needed to generate these programs. The model's Teaching and Learning Database contains information about more than 1,500 educational placements at 165 ambulatory teaching sites (80% in northern New England) involving 320 active preceptors. The centralized office facilitated 36 site visits, 22% of which were interdisciplinary, involving 122 preceptors. A total of 98 follow-up requests by community-based preceptors were fulfilled in 2000. The current submission-to-funding ratio for educational grants is 56%. Costs per educational activity have ranged from $811.50 to $1,938, with costs per preceptor ranging from $101.40 to $217.82. Cost per product (grants, manuscripts, presentations) in research and academic scholarship activities was $2,492. The model allows the medical school to balance institutional and departmental support for its educational programs, and to better position

  4. Community based prevention programs targeting all injuries for children

    Science.gov (United States)

    Spinks, A; Turner, C; McClure, R; Nixon, J

    2004-01-01

    Objective: Community based models for injury prevention have become an accepted part of the overall injury control strategy. This systematic review of the scientific literature examines the evidence for their effectiveness in reducing all-cause injury in children 0–14 years of age. Methods: A comprehensive search of the literature was performed using the following study selection criteria: community based intervention study; children under 14 years; outcome measure was injury rates; and either a community control or an historical control was used in the design. Quality assessment and data abstraction were guided by a standardized procedure and performed independently by two authors. Data synthesis was in tabular and text form with meta-analysis not being possible due to the discrepancy in methods and measures between the studies. Results: Thorough electronic and library search techniques yielded only nine formally evaluated community based all-cause child injury prevention programs that have reported actual injury outcomes. Of these nine studies, seven provided high level evidence where contemporary control communities were used for comparison; the remaining two used a pre and post-design or time trend analysis where historical data from the community were used as the comparison. Only three of the seven studies with contemporary control communities found significant effect of the intervention; the two studies without controls noted significant reductions in injury rates after the intervention period. Conclusion: There is a paucity of research from which evidence regarding the effectiveness of community based childhood injury prevention programs can be obtained and hence a clear need to increase the effort on developing this evidence base. PMID:15178676

  5. Lessons Learned From Community-Based Approaches to Sodium Reduction

    Science.gov (United States)

    Kane, Heather; Strazza, Karen; Losby PhD, Jan L.; Lane, Rashon; Mugavero, Kristy; Anater, Andrea S.; Frost, Corey; Margolis, Marjorie; Hersey, James

    2017-01-01

    Purpose This article describes lessons from a Centers for Disease Control and Prevention initiative encompassing sodium reduction interventions in six communities. Design A multiple case study design was used. Setting This evaluation examined data from programs implemented in six communities located in New York (Broome County, Schenectady County, and New York City); California (Los Angeles County and Shasta County); and Kansas (Shawnee County). Subjects Participants (n = 80) included program staff, program directors, state-level staff, and partners. Measures Measures for this evaluation included challenges, facilitators, and lessons learned from implementing sodium reduction strategies. Analysis The project team conducted a document review of program materials and semi structured interviews 12 to 14 months after implementation. The team coded and analyzed data deductively and inductively. Results Five lessons for implementing community-based sodium reduction approaches emerged: (1) build relationships with partners to understand their concerns, (2) involve individuals knowledgeable about specific venues early, (3) incorporate sodium reduction efforts and messaging into broader nutrition efforts, (4) design the program to reduce sodium gradually to take into account consumer preferences and taste transitions, and (5) identify ways to address the cost of lower-sodium products. Conclusion The experiences of the six communities may assist practitioners in planning community-based sodium reduction interventions. Addressing sodium reduction using a community-based approach can foster meaningful change in dietary sodium consumption. PMID:24575726

  6. Social Networks and Community-Based Natural Resource Management

    Science.gov (United States)

    Lauber, T. Bruce; Decker, Daniel J.; Knuth, Barbara A.

    2008-10-01

    We conducted case studies of three successful examples of collaborative, community-based natural resource conservation and development. Our purpose was to: (1) identify the functions served by interactions within the social networks of involved stakeholders; (2) describe key structural properties of these social networks; and (3) determine how these structural properties varied when the networks were serving different functions. The case studies relied on semi-structured, in-depth interviews of 8 to 11 key stakeholders at each site who had played a significant role in the collaborative projects. Interview questions focused on the roles played by key stakeholders and the functions of interactions between them. Interactions allowed the exchange of ideas, provided access to funding, and enabled some stakeholders to influence others. The exchange of ideas involved the largest number of stakeholders, the highest percentage of local stakeholders, and the highest density of interactions. Our findings demonstrated the value of tailoring strategies for involving stakeholders to meet different needs during a collaborative, community-based natural resource management project. Widespread involvement of local stakeholders may be most appropriate when ideas for a project are being developed. During efforts to exert influence to secure project approvals or funding, however, involving specific individuals with political connections or influence on possible sources of funds may be critical. Our findings are consistent with past work that has postulated that social networks may require specific characteristics to meet different needs in community-based environmental management.

  7. Identification of Factors Influencing Third Birth Transition in Manipur

    Directory of Open Access Journals (Sweden)

    Sharat Singh N

    2011-04-01

    Full Text Available The third birth transition has a negative impact on the national goal of fertility replacement level (2.1 which is to be achieved by 2010. To identify the factors influencing the demographic phenomenon, a cross sectional as well as community based study consisting of 1397 eligible women was conducted in the four valley districts of Manipur under cluster sampling scheme. Analysing the empirical information through SPSS, 42% of the study subjects transit their 3rd birth and its major determinants could be detected to be sex preference, age at marriage, and educational level each at 0.01 probability level of significance.

  8. Implementing a community-based self care training initiative: a process evaluation.

    Science.gov (United States)

    South, Jane; Darby, Frances; Bagnall, Anne-Marie; White, Alan

    2010-11-01

    Within the UK, there is growing recognition that individuals will need to take increased responsibility for managing their own health for there to be improvements in population health. The current evidence base on self care interventions reflects an interest in enhancing self care knowledge, skills and behaviour in relation to the management of long-term conditions. In contrast, this paper reports on a community-based self care initiative that was designed to promote self care approaches in the general population. The principal component was a self care skills training course delivered to groups of lay people in community and workplace settings. Self Care for People was piloted in three primary care trusts and a process evaluation was undertaken. The aim of this paper is to examine the feasibility, relevance and acceptability of the initiative. Qualitative interviews were conducted with a sample of stakeholders involved in implementation including coordinators, trainers and key informants from organisations hosting the course. In total 40 interviews and two focus groups were conducted from 2006 to 2008 and the data were analysed thematically. The evaluation found that implementation was relatively straightforward with few major barriers reported. Recruitment to the self care skills training course took place in both workplace and community group settings, including in organisations supporting socially excluded groups. The course was seen to provide a valuable space for contemplation on personal health, however, participation could raise sensitive issues that needed to be dealt with by skilled facilitators. Motivations for involvement differed markedly in host organisations and different strategies for marketing were adopted. The paper concludes by suggesting that while Self Care for People was both feasible and relevant to different stakeholder groups, there needs to be flexibility in responding to the needs of participants in different settings.

  9. Korean Patient-Perceived Satisfaction Scale of Community-Based Case Management Services (Korean-PSCCM): Development and Psychometric Evaluation.

    Science.gov (United States)

    Park, Claire Su-Yeon; Yoon, Saunjoo L; Yun, Soon-Nyung; Park, Eunok

    2017-01-01

    This study aimed to develop and psychometrically test an instrument for measuring patient-perceived satisfaction with community-based case management services in Korea. The study was conducted in 4 phases: Phase I, development of the instrument; Phase II, pilot testing of the instrument; Phase III, a large-scale study to test reliability and validity; and Phase IV, conversion of the new instrument from Korean to English. The new instrument was determined to have six factors-advocacy of case manager, outcome of care, communication skills, practice of a healthy lifestyle, referral, and recognition of risk factors-and also shown to be reliable.

  10. Planned hospital birth versus planned home birth

    DEFF Research Database (Denmark)

    Olsen, O.; Clausen, J.A.

    2012-01-01

    Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications. This is an update of a Cochrane review first published in 1998....

  11. Gaps and gains from engaging districts stakeholders for community-based health professions education in Uganda: a qualitative study.

    Science.gov (United States)

    Okello, Elialilia S; Nankumbi, Joyce; Ruzaaza, Gad Ndaruhutse; Bakengesa, Evelyn; Gumikiriza, Joy; Arubaku, Wilfred; Acio, Christine; Samantha, Mary; Matte, Michael

    2015-12-01

    Community-based education research and service (COBERS) is a brand of community-based education that has been adopted by the Medical Education and Service for All Ugandans consortium. The COBERS programme is aimed at equipping students in health professional education with the knowledge, attitudes and skills required to provide appropriate health care services. For sustainability purposes, the health professional training institutions have made efforts to involve various stakeholders in the implementation of the programme. However, the actual engagement process and outcome of such efforts have not been documented. This paper documents gaps and gains made in engaging district stakeholders for community-based education. Key informant interviews, focus group discussions and document review were used to collect data. Atlas.ti, computer software for qualitative data was used to aid analysis. The analysis revealed that the adopted engagement model has registered some gains including increased awareness among district leaders about potential opportunities offered by COBERS such as boosting of human resources at health facilities, opportunities for professional development for health care workers at health facilities, and establishment of linkages between prospective employees and employers. However, the engagement model left some gaps in terms of knowledge, awareness and ownership of the programme among some sections of stakeholders. The apparent information gap about the programme among district stakeholders, especially the political leadership, may hinder concerted partnership. The findings highlight the need for health professional education institutions to broaden the scope of actively engaged stakeholders with the district level.

  12. Birth control pill - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100108.htm Birth control pill - series—Normal female anatomy To use the ... produce a successful pregnancy. To prevent pregnancy, birth control pills affect how these organs normally function. Review ...

  13. Vaginal birth - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100198.htm Vaginal birth - series—Normal anatomy To use the sharing features ... vaginal delivery. Please keep in mind that every birth is unique, and your labor and delivery may ...

  14. Preterm Labor and Birth

    Science.gov (United States)

    ... Scientific Name Preterm labor Preterm birth Preterm infant Late-preterm birth ... first-time pregnancies No benefit in treating mildly low thyroid function in pregnancy, NIH Network study finds ...

  15. Community-based research in action: tales from the Ktunaxa community learning centres project.

    Science.gov (United States)

    Stacy, Elizabeth; Wisener, Katherine; Liman, Yolanda; Beznosova, Olga; Lauscher, Helen Novak; Ho, Kendall; Jarvis-Selinger, Sandra

    2014-01-01

    Rural communities, particularly Aboriginal communities, often have limited access to health information, a situation that can have significant negative consequences. To address the lack of culturally and geographically relevant health information, a community-university partnership was formed to develop, implement, and evaluate Aboriginal Community Learning Centres (CLCs). The objective of this paper is to evaluate the community-based research process used in the development of the CLCs. It focuses on the process of building relationships among partners and the CLC's value and sustainability. Semistructured interviews were conducted with key stakeholders, including principal investigators, community research leads, and supervisors. The interview transcripts were analyzed using an open-coding process to identify themes. Key challenges included enacting shared project governance, negotiating different working styles, and hiring practices based on commitment to project objectives rather than skill set. Technological access provided by the CLCs increased capacity for learning and collective community initiatives, as well as building community leads' skills, knowledge, and self-efficacy. An important lesson was to meet all partners "where they are" in building trusting relationships and adapting research methods to fit the project's context and strengths. Successful results were dependent upon persistence and patience in working through differences, and breaking the project into achievable goals, which collectively contributed to trust and capacity building. The process of building these partnerships resulted in increased capacity of communities to facilitate learning and change initiatives, and the capacity of the university to engage in successful research partnerships with Aboriginal communities in the future.

  16. Community-based maternity care from the view of Iranian midwives: A phenomenological study

    Science.gov (United States)

    Kohan, Shahnaz; Sayyedi, Marziyeh; Nekuei, Nafisehsadat; Yousefi, Hojatollah

    2015-01-01

    Background: Midwifery cares take place in diverse communities with different ethnics groups. Therefore, midwifery cares could be planned wisely and principally based on women's and their families’ changeable demands which focus on social and cultural issues. This qualitative study explored the midwives’ experiences of care in the community. Materials and Methods: This qualitative study was conducted by descriptive phenomenological approach. The subjects, selected by purposive sampling, comprised 13 midwives employed in Isfahan, Iran. Semi-structured interviews were audio-taped, transcribed, and simultaneously analyzed through Colaizzi's method. Results: With descriptive analysis of participants’ experiences, three main themes were explored (personal characteristics of the community midwife, social determinants of women's health, and achieving community-based midwifery skills). Conclusions: Knowledge of women's social status, gender inequality in health, and existence of social health risk factors for women in their community helps midwives to provide reproductive health care based on clients’ needs and demands. Therefore, midwives should enhance the quality of their care through integrating professional skills with a full understanding of the social context. PMID:25709700

  17. Planning for Community Based Tourism in a Remote Location

    Directory of Open Access Journals (Sweden)

    Sharon Harwood

    2010-07-01

    Full Text Available Remote areas are difficult to access, tend to lack critical infrastructure, are highly susceptible to shocks in the marketplace, and are perceived by industry to possess limited development opportunities. Accordingly a community orientated and territorial approach to development planning in a remote area will be more successful than a top down industry based approach [1]. Given the limitations of being remote, the case study community examined in this research manages and sustains a bird watching tourism product within a global market place. This paper examines how a remotely located community in the Arfak Mountains of West Papua overcomes these difficulties and plans for community based tourism (CBT in their locale.

  18. Do Medicaid home and community based service waivers save money?

    Science.gov (United States)

    Harrington, Charlene; Ng, Terence; Kitchener, Martin

    2011-10-01

    This article estimates the potential savings to the Medicaid program of using 1915c Home and Community Based Services (HCBS) waivers rather than institutional care. For Medicaid HCBS waiver expenditures of $25 billion in 2006, we estimate the national savings to be over $57 billion, or $57,338 per waiver participant in 2006 compared with the cost of Medicaid institutional care (for which all waiver participants are eligible). When taking into account a potential 50% "woodwork effect" (for people who might have refused institutional services), the saving would be $21 billion. This analysis demonstrates that HCBS waiver programs present significant direct financial savings to Medicaid long-term care (LTC) programs.

  19. Birth Control Pill

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Birth Control Pill KidsHealth > For Teens > Birth Control Pill Print A A A What's in this ... La píldora anticonceptiva What Is It? The birth control pill (also called "the Pill") is a daily ...

  20. Birth Control Patch

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Birth Control Patch KidsHealth > For Teens > Birth Control Patch Print A A A What's in this ... Does It Cost? What Is It? The birth control patch is a thin, beige, 1¾-inch (4½- ...

  1. Birth Control Shot

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Birth Control Shot KidsHealth > For Teens > Birth Control Shot Print A A A What's in this ... La inyección anticonceptiva What Is It? The birth control shot is a long-acting form of progesterone, ...

  2. Contraception and Birth Control

    Science.gov (United States)

    ... to the NICHD Staff Directory Skip sharing on social media links Rollup Image Home > Health & Research > A-Z Topics > Contraception and Birth Control > About Page Content ​About Contraception and Birth Control Contraception is the prevention of pregnancy. Contraception, or birth control, also allows couples to ...

  3. Encyclopedia of Birth Control.

    Science.gov (United States)

    Rengel, Marian

    This encyclopedia brings together in more than 200 entries, arranged in A-to-Z format, a portrait of the complex modern issue that birth control has become with advances in medicine and biochemistry during the 20th century. It is aimed at both the student and the consumer of birth control. Entries cover the following topics: birth control…

  4. Birth Control Ring

    Science.gov (United States)

    ... Right Sport for You Healthy School Lunch Planner Birth Control Ring KidsHealth > For Teens > Birth Control Ring Print A A A What's in ... español Anillo vaginal anticonceptivo What Is It? The birth control ring is a soft, flexible, doughnut-shaped ...

  5. Encyclopedia of Birth Control.

    Science.gov (United States)

    Rengel, Marian

    This encyclopedia brings together in more than 200 entries, arranged in A-to-Z format, a portrait of the complex modern issue that birth control has become with advances in medicine and biochemistry during the 20th century. It is aimed at both the student and the consumer of birth control. Entries cover the following topics: birth control…

  6. Birth Control Patch

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Birth Control Patch KidsHealth > For Teens > Birth Control Patch A A A What's in this article? ... Much Does It Cost? What Is It? The birth control patch is a thin, beige, 1¾-inch (4½- ...

  7. Birth Control Pill

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Birth Control Pill KidsHealth > For Teens > Birth Control Pill A A A What's in this article? ... español La píldora anticonceptiva What Is It? The birth control pill (also called "the Pill") is a daily ...

  8. Birth Control Ring

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Birth Control Ring KidsHealth > For Teens > Birth Control Ring A A A What's in this article? ... español Anillo vaginal anticonceptivo What Is It? The birth control ring is a soft, flexible, doughnut-shaped ring ...

  9. Birth Control Shot

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Birth Control Shot KidsHealth > For Teens > Birth Control Shot A A A What's in this article? ... español La inyección anticonceptiva What Is It? The birth control shot is a long-acting form of progesterone, ...

  10. Birth Defects (For Parents)

    Science.gov (United States)

    ... this virus during pregnancy, her child may have low birth weight, intellectual disability (mental retardation) or learning disabilities, ... and central nervous system problems. A child with late congenital syphilis may have abnormalities of the ... Diagnosing Birth Defects Many birth defects are diagnosed even before ...

  11. Impact of community-based interventions for the prevention and control of malaria on intervention coverage and health outcomes for the prevention and control of malaria.

    Science.gov (United States)

    Salam, Rehana A; Das, Jai K; Lassi, Zohra S; Bhutta, Zulfiqar A

    2014-01-01

    In this paper, we aim to evaluate the effectiveness of community-based interventions (CBIs) for the prevention and management of malaria. We conducted a systematic review and identified 42 studies for inclusion. Twenty-five of the included studies evaluated the impact of the community-based distribution of insecticide-treated nets (ITNs), indoor residual spraying (IRS), or impregnated bed sheets; 14 studies evaluated intermittent preventive therapy (IPT) delivered in community settings; two studies focused on community-based education for malaria prevention; and one study evaluated environmental management through drain cleaning. Our analysis suggests that, overall, the community-based delivery of interventions to prevent and control malaria resulted in a significant increase in ITNs ownership (RR: 2.16, 95% CI: 1.86, 2.52) and usage (RR: 1.77, 95% CI: 1.48, 2.11). However, usage of ITNs was limited to two-thirds of the population who owned them. Community-based strategies also led to a significant decrease in parasitemia (RR: 0.56, 95% CI: 0.42, 0.74), malaria prevalence (RR: 0.46, 95% CI: 0.29, 0.73), malaria incidence (RR: 0.70, 95% CI: 0.54, 0.90), and anemia prevalence (RR: 0.79, 95% CI: 0.64, 0.97). We found a non-significant impact on splenomegaly, birth outcomes (low birth weight, prematurity, stillbirth/miscarriage), anthropometric measures (stunting, wasting, and underweight), and mortality (all-cause and malaria-specific). The subgroup analysis suggested that community-based distribution of ITNs, impregnated bed sheets and IRS, and IPT are effective strategies. Qualitative synthesis suggests that high coverage could be achieved at a lower cost with the integration of CBIs with existing antenatal care and immunization campaigns. Community-based delivery of interventions to prevent and control malaria are effective strategies to improve coverage and access and reduce malaria burden, however, efforts should also be concerted to prevent over diagnosis and

  12. Teaching Our Own Babies: Teachers' Life Journeys into Community - Based Initial Education in Indigenous Oaxaca, Mexico

    Directory of Open Access Journals (Sweden)

    Lois M. Meyer

    2016-02-01

    Full Text Available In an era when U.S. and Mexican teachers are valued more for their academic achievements than their community-based knowledge and local/ethnic identity (e.g. Teach for America, or its off-shoot, Teach for Mexico, this study provides initial results of a one-year (2011-2012 intensive professional development experience (called a diplomado for 35 indigenous teachers of Initial Education who are “teaching their own babies” in marginalized communities of Oaxaca, Mexico, as documented in portfolios of written and photographic evidence produced by the teachers as their final diplomado product. The goal was to enrich these local teachers' background knowledge and equip them with research skills to investigate and honor the communal practices, governance, and perspectives (known as comunalidad of the rural indigenous communities where they teach, in order to generate an authentic, community-based approach to Initial Education for pregnant mothers, babies and toddlers up to 3 years old – a ground-breaking alternative to the Mexican government’s homogeneous Initial Education approach. Early findings indicate that these Oaxacan indigenous teachers faced a complex of internal and external challenges in this radical, regenerative work: they are young, female, mostly novice teachers, they lack professional preparation, and they have confronted racism throughout their own lives, especially and intensely in Mexican public schools. In the process of documenting communal life and early childhood socialization practices in rural communities where they teach, they confronted their own (often uneasy biculturalism and bilingualism. “Communalizing” early education in indigenous Oaxaca involves reconstructing and revitalizing the indigenous identities and language use of children and teachers alike. Preparing these local indigenous teachers to “teach their own babies” is a challenging but invaluable and achievable task.

  13. Lessons learnt from comprehensive evaluation of community-based education in Uganda: a proposal for an ideal model community-based education for health professional training institutions

    Directory of Open Access Journals (Sweden)

    Atuyambe Lynn

    2011-03-01

    Full Text Available Abstract Background Community-based education (CBE can provide contextual learning that addresses manpower scarcity by enabling trainees acquire requisite experiences, competence, confidence and values. In Uganda, many health professional training institutions conduct some form of community-based education (CBE. However, there is scanty information on the nature of the training: whether a curriculum exists (objectives, intended outcomes, content, implementation strategy, administration and constraints faced. The objective was to make a comprehensive assessment of CBE as implemented by Ugandan health professional training institutions to document the nature of CBE conducted and propose an ideal model with minimum requirements for health professional training institutions in Uganda. Methods We employed several methods: documentary review of curricula of 22 institutions, so as to assess the nature, purpose, outcomes, and methods of instruction and assessment; site visits to these institutions and their CBE sites, to assess the learning environment (infrastructure and resources; in-depth interviews with key people involved in running CBE at the institutions and community, to evaluate CBE implementation, challenges experienced and perceived solutions. Results CBE was perceived differently ranging from a subject, a course, a program or a project. Despite having similar curricula, institutions differ in the administration, implementation and assessment of CBE. Objectives of CBE, the curricula content and implementation strategies differ in similar institutions. On collaborative and social learning, most trainees do not reside in the community, though they work on group projects and write group reports. Lectures and skills demonstrations were the main instruction methods. Assessment involved mainly continuous assessment, oral or written reports and summative examination. Conclusion This assessment identified deficiencies in the design and implementation

  14. Saving lives at birth

    DEFF Research Database (Denmark)

    Daysal, N. Meltem; Trandafir, Mircea; van Ewijk, Reyn

    2015-01-01

    Many developed countries have recently experienced sharp increases in home birth rates. This paper investigates the impact of home births on the health of low-risk newborns using data from the Netherlands, the only developed country where home births are widespread. To account for endogeneity...... in location of birth, we exploit the exogenous variation in distance from a mother’s residence to the closest hospital. We find that giving birth in a hospital leads to substantial reductions in newborn mortality. We provide suggestive evidence that proximity to medical technologies may be an important...

  15. Autism Spectrum Disorder in a Community-based Sample with Neurodevelopmental Problems in Lagos, Nigeria

    Science.gov (United States)

    Olagunju, Andrew T.; Oyelohunnu, Motunrayo. A.; Campbell, Elizabeth A.; Umeh, Charles S.; Aina, Olatunji F.; Oyibo, Wellington; Lesi, Folusho E.A.; Adeyemi, Joseph D.

    2017-01-01

    Autism Spectrum Disorder (ASD) is a globally prevalent neurodevelopmental disorder for which early diagnosis and intervention is the mainstay of management. In the African continent, limited data is available regarding the non-clinic based samples. Lack of information available to caregivers and inadequate skilled manpower often limit early detection and access to the few available though under resourced services in the community. Community based screening can be an important drive to create awareness and improve information dissemination regarding services available for those living with this disorder. This is a descriptive cross-sectional study utilizing data obtained from participants of a community-based autism screening exercise. The surveillance exercise was part of the annual Orange Ribbon initiative for autism awareness and screening held in 2014. Data was obtained from 85 participants involved in the Autism Surveillance screening exercise within the Lagos community. Community public service radio announcements state wide and word of mouth were used to invite and enroll eligible participants to the screening and consultation exercise. A second stage screening and a brief sociodemographic questionnaire followed by a third stage clinical interview and evaluation using the Diagnostic and Statistical Manual of Mental Disorders - 5 Edition (DSM 5) were used. Appropriate consultation and referrals to services in the community were given. Participants had a mean age of 7.53 years (SD 4.35). Twenty-nine (34.5%) met the diagnosis of ASD. Other diagnosis included attention deficit hyperactivity disorder (ADHD), language and speech disorder, intellectual disability (8.3%) and learning disorders (9.5%). Main health concerns to caregivers were poor language development in all (100%), of which 11 (40.7%) were non-verbal; gaze avoidance was seen in 14 (48.3%) and challenging behavior in 12 (42.9%). Comorbidities included seizure disorders (3.4%) and ADHD (6.9%). Persons

  16. Autism spectrum disorder in a community-based sample with neurodevelopmental problems in Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Yewande O. Oshodi

    2017-01-01

    Full Text Available Autism Spectrum Disorder (ASD is a globally prevalent neurodevelopmental disorder for which early diagnosis and intervention is the mainstay of management. In the African continent, limited data is available regarding the non-clinic based samples. Lack of information available to caregivers and inadequate skilled manpower often limit early detection and access to the few available though under resourced services in the community. Community based screening can be an important drive to create awareness and improve information dissemination regarding services available for those living with this disorder. This is a descriptive cross-sectional study utilizing data obtained from participants of a community-based autism screening exercise. The surveillance exercise was part of the annual Orange Ribbon initiative for autism awareness and screening held in 2014. Data was obtained from 85 participants involved in the Autism Surveillance screening exercise within the Lagos community. Community public service radio announcements state wide and word of mouth were used to invite and enroll eligible participants to the screening and consultation exercise. A second stage screening and a brief sociodemographic questionnaire followed by a third stage clinical interview and evaluation using the Diagnostic and Statistical Manual of Mental Disorders - 5 Edition (DSM 5 were used. Appropriate consultation and referrals to services in the community were given. Participants had a mean age of 7.53 years (SD 4.35. Twenty-nine (34.5% met the diagnosis of ASD. Other diagnosis included attention deficit hyperactivity disorder (ADHD, language and speech disorder, intellectual disability (8.3% and learning disorders (9.5%. Main health concerns to caregivers were poor language development in all (100%, of which 11 (40.7% were non-verbal; gaze avoidance was seen in 14 (48.3% and challenging behavior in 12 (42.9%. Comorbidities included seizure disorders (3.4% and ADHD (6

  17. Community-based oil spill response in Alaska

    Energy Technology Data Exchange (ETDEWEB)

    Banta, J. [Prince William Sound Regional Citizen' s Advisory Council, Anchorage, AK (United States); Munger, M. [Cook Inlet Regional Citizen' s Advisory Council, Kenai, AK (United States)

    2006-07-01

    The Prince William Sound Regional Citizen's Advisory Council and the Cook Inlet Regional Citizen's Advisory Council are independent, non profit organizations formed in 1989 following the Exxon Valdez oil spill to promote the concept of community-based oil spill response (COSR) in their respective regions. COSR involves local citizens in responding to oil spilled in waters they rely upon for income, recreation and subsistence. The 2 advisory councils recently held a Community Oil Spill Response Forum to review the status of existing COSR teams and to share information about past and future COSR-related efforts. The meeting served as an information exchange process about regulatory programs, COSR variations in communities and harbors, training, and personnel issues. Key groups attending the forum were harbor masters, Alaska Department of Environmental Conservation, United States Coast Guard, existing COSR teams, oil response organizations, local community governments, and volunteers from the advisory councils. This paper was based on the notes taken from the forum. It was agreed that the current system is inadequate in its response to small spills that are frequently associated with non-tank vessels. It was suggested that improved capacity for community-based response could address the situation. It was also suggested that work groups should meet on an annual or biannual basis to continue to educate responders and communities about oil spill response. 7 refs.

  18. Community-based benchmarking of the CMIP DECK experiments

    Science.gov (United States)

    Gleckler, P. J.

    2015-12-01

    A diversity of community-based efforts are independently developing "diagnostic packages" with little or no coordination between them. A short list of examples include NCAR's Climate Variability Diagnostics Package (CVDP), ORNL's International Land Model Benchmarking (ILAMB), LBNL's Toolkit for Extreme Climate Analysis (TECA), PCMDI's Metrics Package (PMP), the EU EMBRACE ESMValTool, the WGNE MJO diagnostics package, and CFMIP diagnostics. The full value of these efforts cannot be realized without some coordination. As a first step, a WCRP effort has initiated a catalog to document candidate packages that could potentially be applied in a "repeat-use" fashion to all simulations contributed to the CMIP DECK (Diagnostic, Evaluation and Characterization of Klima) experiments. Some coordination of community-based diagnostics has the additional potential to improve how CMIP modeling groups analyze their simulations during model-development. The fact that most modeling groups now maintain a "CMIP compliant" data stream means that in principal without much effort they could readily adopt a set of well organized diagnostic capabilities specifically designed to operate on CMIP DECK experiments. Ultimately, a detailed listing of and access to analysis codes that are demonstrated to work "out of the box" with CMIP data could enable model developers (and others) to select those codes they wish to implement in-house, potentially enabling more systematic evaluation during the model development process.

  19. Community based rehabilitation: a strategy for peace-building

    Directory of Open Access Journals (Sweden)

    Hodgson Jennifer

    2002-11-01

    Full Text Available Abstract Background Certain features of peace-building distinguish it from peacekeeping, and make it an appropriate strategy in dealing with vertical conflict and low intensity conflict. However, some theorists suggest that attempts, through peace-building, to impose liberal values upon non-democratic cultures are misguided and lack an ethical basis. Discussion We have been investigating the peace-building properties of community based approaches to disability in a number of countries. This paper describes the practice and impact of peace-building through Community Based Rehabilitation (CBR strategies in the context of armed conflict. The ethical basis for peace-building through practical community initiatives is explored. A number of benefits and challenges to using CBR strategies for peace-building purposes are identified. Summary During post-conflict reconstruction, disability is a powerful emotive lever that can be used to mobilize cooperation between factions. We suggest that civil society, in contrast to state-level intervention, has a valuable role in reducing the risks of conflict through community initiatives.

  20. Evaluating complex community-based health promotion: addressing the challenges.

    Science.gov (United States)

    Jolley, Gwyneth

    2014-08-01

    Community-based health promotion is poorly theorised and lacks an agreed evidence-base. This paper examines characteristics of community-based health promotion and the challenges they present to evaluation. A review of health promotion evaluation leads to an exploration of more recent approaches, drawing on ideas from complexity theory and developmental evaluation. A reflexive analysis of three program evaluations previously undertaken as an evaluation consultant is used to develop a conceptual model to help in the design and conduct of health promotion evaluation. The model is further explored by applying it retrospectively to one evaluation. Findings suggest that the context-contingent nature of health promotion programs; turbulence in the community context and players; multiple stakeholders, goals and strategies; and uncertainty of outcomes all contribute to the complexity of interventions. Bringing together insights from developmental evaluation and complexity theory can help to address some evaluation challenges. The proposed model emphasises recognising and responding to changing contexts and emerging outcomes, providing rapid feedback and facilitating reflexive practice. This will enable the evaluator to gain a better understanding of the influence of context and other implementation factors in a complex setting. Use of the model should contribute to building cumulative evidence and knowledge in order to identify the principles of health promotion effectiveness that may be transferable to new situations.

  1. Innovations in community-based nursing education: transitioning faculty.

    Science.gov (United States)

    Carter, Kimberly Ferren; Fournier, Maggie; Grover, Susan; Kiehl, Ermalynn M; Sims, Kathleen M

    2005-01-01

    The health-care climate is changing rapidly and in ways that challenge the abilities of professionals who provide health care. Nursing educators are preparing professional nurses who can think critically, use sound clinical judgment, and participate as full partners in shaping health-care delivery and policy. Therefore, many schools of nursing, including five schools of nursing whose experiences are synthesized in this article, are revising their curricula to a community-based nursing perspective. Strategies to assist faculty in the transition to a community-based nursing curriculum include using change theory, creating a supportive environment, reducing tension and isolation, and evaluating. Potential challenges during transition include addressing grief and loss, overcoming the tedium of curricular development, moving the revision along while allowing opportunities for faculty input and consensus building, exploring alternative pedagogies, managing faculty workload and qualification issues, and preparing for transition. Outcomes include a more complete understanding of the community client as a partner in the delivery of health care, increased visibility and role modeling to potential future candidates for health careers, cultural transformations within a university, and promotion of the overall health of a community.

  2. Anthropometric measurements for detecting low birth weight

    Directory of Open Access Journals (Sweden)

    Kusharisupeni

    2013-05-01

    Full Text Available Background In several provinces of Eastern Indonesia, the majority of births take place at home (60% and are assisted by traditional birth attendants. Most of these newborns do not have their birth weight recorded, due to lack of available weighing scales or lack of skill to perform the measurement, especially in rural areas. As such, an early identification of low birth weight cases is needed to prevent infant morbidity and mortality. Objective To assess anthropometric measurements including calf, chest, and head circumferences as a method of choice for detecting low birth weight, as substitute for actual weighing. Methods This cross-sectional study was performed at Banjar Baru, South Kalimantan, Indonesia, from January to March 2012. Subjects were full term, singleton, and live-born infants during the study period, and obtained from private clinics by a purposive sampling procedure. Calf, chest, and head circumferences were measured to identify the most suitable substitute for birth weight using Pearson’s correlation, ROC, sensitivity, and specificity. Results In this study, a correlation was shown between birth weight and all anthropometric measurements. Optimal calf, chest, and head circumference cutoff points to identify low birth weight infants were 10.3 cm, 30.7 cm, and 31.2 cm, respectively. The area under the curves (AUC showed good accuracy for all measurement types. Calf circumference had the closest estimated true prevalence to the true prevalence (8� .52% and 8.6%, respec-.52% respec- 52% respec-%8.6%, respec-.6%, 6%, respec-%, respectively compared to the other measurement types. Conclusion Calf circumference is the most suitable measurement as a substitute for birth weight, due to its estimated true prevalence. [Paediatr Indones. 2013;53:177-80.].

  3. Anthropometric measurements for detecting low birth weight

    Directory of Open Access Journals (Sweden)

    Kusharisupeni

    2013-01-01

    Full Text Available Background In several provinces of Eastern Indonesia, the majority of births take place at home (60% and are assisted by traditional birth attendants. Most of these newborns do not have their birth weight recorded, due to lack of available weighing scales or lack of skill to perform the measurement, especially in rural areas. As such, an early identification of low birth weight cases is needed to prevent infant morbidity and mortality.Objective To assess anthropometric measurements including calf, chest, and head circumferences as a method of choice for detecting low birth weight, as substitute for actual weighing.Methods This cross-sectional study was performed at Banjar Baru, South Kalimantan, Indonesia, from January to March 2012. Subjects were full term, singleton, and live-born infants during the study period, and obtained from private clinics by a purposive sampling procedure. Calf, chest, and head circumferences were measured to identify the most suitable substitute for birth weight using Pearson’s correlation, ROC, sensitivity, and specificity.Results In this study, a correlation was shown between birth weight and all anthropometric measurements. Optimal calf, chest, and head circumference cutoff points to identify low birth weight infants were 10.3 cm, 30.7 cm, and 31.2 cm, respectively. The area under the curves (AUC showed good accuracy for all measurement types. Calf circumference had the closest estimated true prevalence to the true prevalence (8� .52% and 8.6%, respec-.52% respec- 52% respec-%8.6%, respec-.6%, 6%, respec-%, respectively compared to the other measurement types.Conclusion Calf circumference is the most suitable measurement as a substitute for birth weight, due to its estimated true prevalence.

  4. A COMMUNITY BASED STUDY ON INFANT AND YOUNG FEEDING PRACTICES IN A RURAL AREA OF KARNATAKA

    Directory of Open Access Journals (Sweden)

    Sharvanan Udayar

    2012-09-01

    Full Text Available ABSTRACT: BACKGROUND: Adequate nutrition during infancy and early childho od is critical to the development of children’s full human potential . OBJECTIVE : The main objective was to assess the Infant and Young Child Feeding (IYCF pra ctices and associated socio demographic variables among children aged less than two years i n rural areas METHODS: A community based, cross sectional descriptive study was done du ring Sept 09-Aug 2010 which is the rural field practice area of Shri. B. M. Patil Medical Col lege SBMPMC. The data was computed and analyzed using SPSS statistical package (version 13. 0. RESULTS: During the study period 264 mothers of infants and young children interviewed w ith the questionnaire and 159 out of 264 had received prelacteal feeds (males 64 % and female s56.3 %. Illiterate mothers (69.7% practiced more prelacteal feeding than the literate m others (54.6%. 36% received exclusive breast feeding for a period six months. Majority of the illiterate mothers were practicing early (31.4% and delayed weaning (32.5%.Poor socioecono mic status, illiteracy, birth spacing and cultural beliefs had significant effect on infant a nd young children feeding practices. CONCLUSIONS: The study re-emphasized the need for conducting con tinued infant and child feeding intervention programmes especially for the mo ther during antenatal and postnatal checkups.

  5. Determinants of Complementary Feeding Practices among Children Aged 6-23: a Community based Study

    Directory of Open Access Journals (Sweden)

    Aziz Kamran

    2017-03-01

    Full Text Available BackgroundComplementary feeding practices play an important role in growth and development of the children. This study aimed to determine the complementary feeding practices status among children aged 6- 23 months and its association with various socio- demographic factors.Materials and MethodsThis community based cross-sectional study was conducted at field practice area of Urban Health Centers in Khalkhal city, North West of Iran. In the preset study 576 mothers of children aged 6-23 months were selected with multistage random sampling method and interviewed using structured questionnaire for Infant and Young Child Feeding (IYCF indicators (minimum dietary diversity (MDD, minimum meal frequency (MMF, and minimum acceptable diet (MAD. Data were analyzed with using SPSS-20.0, Chi-square, bivariate and multivariate logistic regression tests.ResultsFindings showed that MDD, MMF and MAD were adequate in 42.3%, 42.7% and 30.9%, respectively. MDD and MAD was significantly associated with gender of child, type of delivery, birth order of child, mothers literacy and health literacy (P

  6. Planned place of birth

    DEFF Research Database (Denmark)

    Overgaard, Charlotte; Coxon, Kirstie; Stewart, Mary

    Title Planned place of birth: issues of choice, access and equity. Outline In Northern European countries, giving birth is generally safe for healthy women with uncomplicated pregnancies, and their babies. However, place of birth can affect women’s outcomes and experiences of birth. Whilst tertiary...... centres provide appropriate medical supervision to women with complex pregnancies, the likelihood of receiving interventions including surgical birth is increased for low risk women in these settings. In this symposium, we consider issues of choice, access and equitable care for women in the context...... in Denmark Coxon K et al: Planned place of birth in England: perceptions of accessing obstetric units, midwife led units and home birth amongst women and their partners. How these papers interrelate These papers draw upon recent research in maternity care, undertaken in Denmark and in England. In both...

  7. A Place to Begin: Engaging Parents with Their Baby Before Birth

    Science.gov (United States)

    Gilkerson, Linda; Wechsler, Nick

    2014-01-01

    The Community-Based Family Administered Neonatal Activities (C-B FANA; Cardone, Gilkerson, & Wechsler, 2005) offers home visitors and expectant parents a new way to be together during the unfolding months before birth. Adapted from the hospital-based Family Administered Neonatal Activities (FANA; Cardone & Gilkerson, 1990), the C-B FANA…

  8. Haemorrhage after home birth: audit of decision making and referral : Part 2 : Results and discussion

    NARCIS (Netherlands)

    Smit, M.; Dijkman, A.; Rijnders, M.; Bustraan, J.; Dillen, J. van; Middeldorp, J.; Havenith, B.; Roosmalen, J. van

    2013-01-01

    In the Netherlands, 20 per cent of women give birth at home. In 0.7 per cent, referral to secondary care because of postpartum haemorrhage (PPH) is indicated. Midwives are regularly trained in managing obstetric emergencies. A postgraduate training programme developed for Dutch community-based midwi

  9. Penerapan Corporate Social Responsibility dengan Konsep Community Based Tourism

    Directory of Open Access Journals (Sweden)

    Linda Suriany

    2013-12-01

    Full Text Available Abstract: Business is not only economic institution, but social institution too. As social institution, business has responsibility to help society in solving social problem. This responsibility called Corporate Social Responsibility (CSR. CSR pays attention about social problem and environment, so CSR support continuous development to help government role. Nowadays, our government has national development’s agenda. One of them is tourism sector (Visit Indonesia Year 2008 programmed. But tourism sector has challenge in human resources. In this case, business role in practice CSR is needed to help tourism sector. With CSR activities, the quality of local community will increase to participate in tourism activities. CSR activities include training that based on research. When the quality of local community increase, local community can practice the concept of community based tourism (CBT. In the future, Indonesia has a power to compete with other countries.

  10. A Community-Based Approach to Identifying Influential Spreaders

    Directory of Open Access Journals (Sweden)

    Zhiying Zhao

    2015-04-01

    Full Text Available Identifying influential spreaders in complex networks has a significant impact on understanding and control of spreading process in networks. In this paper, we introduce a new centrality index to identify influential spreaders in a network based on the community structure of the network. The community-based centrality (CbC considers both the number and sizes of communities that are directly linked by a node. We discuss correlations between CbC and other classical centrality indices. Based on simulations of the single source of infection with the Susceptible-Infected-Recovered (SIR model, we find that CbC can help to identify some critical influential nodes that other indices cannot find. We also investigate the stability of CbC.

  11. Community-based Participatory Research: Necessary Next Steps

    Directory of Open Access Journals (Sweden)

    Zubaida Faridi, MBBS, MPH

    2007-07-01

    Full Text Available Community-based participatory research (CBPR is gaining increasing credence among public health researchers and practitioners. However, there is no standardization in assessing the quality of research methods, the effectiveness of the interventions, and the reporting requirements in the literature. The absence of standardization precludes meaningful comparisons of CBPR studies. Several authors have proposed a broad set of competencies required for CBPR research for both individuals and organizations, but the discussion remains fragmented. The Prevention Research Centers (PRC Program recently began a qualitative assessment of its national efforts, including an evaluation of how PRCs implement CBPR studies. Topics of interest include types of community partnerships; community capacity for research, evaluation, and training; and factors that help and hinder partner relationships. The assessment will likely contribute to the development of a standard set of competencies and resources required for effective CBPR.

  12. Community-Based Rural Tourism: A Proposed Sustainability Framework

    Directory of Open Access Journals (Sweden)

    Kayat Kalsom

    2014-01-01

    Full Text Available Many tourism projects run by community in the rural areas are labelled as Community-based Rural Tourism (CBRT, a type of a more ‘responsible’ tourism that contributes to sustainable development. However, a framework is needed to enable planners and managers to understand its criteria thus ensuring that the CBRTs fulfil the sustainability requirement. This paper presents findings from a literature review on previous writings in this topic. Findings from an analysis on the criteria of a sustainable CBRT product are discussed. It is found that in order for it to play a role in sustainable development, a CBRT product must focus on competitive management, resource conservation, and benefit creation to the community. The three elements need to be supported, in turn, by community involvement and commitment. As the proposed conceptual framework of sustainable CBRT product can be a basis for further research in CBRT, it offers producing theoretical and practical implications.

  13. Comparing student role perceptions: traditional to community-based curriculum.

    Science.gov (United States)

    Nickerson, Carolyn; Resick, Lenore K

    2010-01-01

    This phenomenological study explored role perceptions of senior baccalaureate nursing students in a traditional curriculum (TC) and a community-based curriculum (CBC) following one U.S. school's curriculum revision. Researchers inquired into that moment when students intervened like a nurse. Results were analyzed by groups and then compared. The assumptions and style of the Dutch school of phenomenology guided the collection and analysis of data. Among identified themes were traditional nursing role functions. Students from the CBC perceived a comparatively broader scope for nursing practice, broader definition of client, and a more nuanced description of the nurse's role. Seniors from the TC described a developmental trajectory which culminated in being able to intervene like a nurse. Responses from both participant groups confirm the importance of nurse-client and nurse-nurse proximities for the development of professional nursing in both structured and unstructured settings.

  14. Integrated community-based dementia care: the Geriant model

    Directory of Open Access Journals (Sweden)

    Ludo Glimmerveen

    2015-09-01

    Full Text Available This article gives an in-depth description of the service delivery model of Geriant, a Dutch organization providing community-based care services for people suffering from dementia. Core to its model is the provision of clinical case management, embedded in multidisciplinary dementia care teams. As Geriant's client group includes people from the first presumption of dementia until they can no longer live at home, its care model provides valuable lessons about how different mechanisms of integration are flexibly put to use if the complexity of clients” care needs increases. It showcases how the integration of services for a specific sub-population is combined with alignment of these services with generalist network partners. After a detailed description of the programme and its results, this article builds on the work of Walter Leutz for a conceptual discussion of Geriant's approach to care integration. 

  15. COMMUNITY-BASED ECOTOURISM IN NATURE RESERVE OF CHINA

    Institute of Scientific and Technical Information of China (English)

    GUI Yan-li; FANG Yan-gang; LIU Ji-sheng

    2004-01-01

    This paper introduces a new concept of community-based ecotourism (CBET) that originated in foreign countries.Then it analyzes the significance ofCBET development in nature reserve (NR).The authors think that community participation is the evitable choice of nature reserve's conservation and development.CBET,as the self-improved model of ecotourism,can promote tourism community sustainable development.Based on the stakeholder analysis of CBET in NRs,this paper addresses the reality,especially the problem of CBET development in NRs of China.In order to develop CBET in NRs of China,this paper takes some suggestions to promote the community participation:1)gradual political empowerment,2) deep level economic incentive,3) widespread educational support,4) impartial distribution of community benefits,and 5) stakeholders cooperation.

  16. Efficient community-based control strategies in adaptive networks

    CERN Document Server

    Yang, Hui; Zhang, Hai-Feng

    2012-01-01

    Most researches on adaptive networks mainly concentrate on the properties of steady state, but neglect transient dynamics. In this study, we pay attention to the emergence of community structures in transient process and the effects of community-based control strategies on epidemic spreading. First, by normalizing modularity $Q$, we investigate the evolution of community structures during the transient process, and find that very strong community structures are induced by rewiring mechanism in the early stage of epidemic spreading, which remarkably delays the outbreaks of epidemic. Then we study the effects of control strategies started from different stages on the prevalence. Both immunization and quarantine strategies indicate that it is not "the earlier, the better" for the implementing of control measures. And the optimal control effect is obtained if control measures can be efficiently implemented in the period of strong community structure. For immunization strategy, immunizing the S nodes on SI links a...

  17. A community-based, interdisciplinary rehabilitation engineering course.

    Science.gov (United States)

    Lundy, Mary; Aceros, Juan

    2016-08-01

    A novel, community-based course was created through collaboration between the School of Engineering and the Physical Therapy program at the University of North Florida. This course offers a hands-on, interdisciplinary training experience for undergraduate engineering students through team-based design projects where engineering students are partnered with physical therapy students. Students learn the process of design, fabrication and testing of low-tech and high-tech rehabilitation technology for children with disabilities, and are exposed to a clinical experience under the guidance of licensed therapists. This course was taught in two consecutive years and pre-test/post-test data evaluating the impact of this interprofessional education experience on the students is presented using the Public Service Motivation Scale, Civic Actions Scale, Civic Attitudes Scale, and the Interprofessional Socialization and Valuing Scale.

  18. A community-based framework for aquatic ecosystem models

    DEFF Research Database (Denmark)

    Trolle, Didde; Hamilton, D. P.; Hipsey, M. R.;

    2012-01-01

    aim to (i) advance collaboration within the aquatic ecosystem modelling community, (ii) enable increased use of models for research, policy and ecosystem-based management, (iii) facilitate a collective framework using common (standardised) code to ensure that model development is incremental, (iv......Here, we communicate a point of departure in the development of aquatic ecosystem models, namely a new community-based framework, which supports an enhanced and transparent union between the collective expertise that exists in the communities of traditional ecologists and model developers. Through...... a literature survey, we document the growing importance of numerical aquatic ecosystem models while also noting the difficulties, up until now, of the aquatic scientific community to make significant advances in these models during the past two decades. Through a common forum for aquatic ecosystem modellers we...

  19. Community-based adaptation to climate change: an update

    Energy Technology Data Exchange (ETDEWEB)

    Ayers, Jessica; Huq, Saleemul

    2009-06-15

    Over a billion people - the world's poorest and most bulnerable communities – will bear the brunt of climate change. For them, building local capacity to cope is a vital step towards resilience. Community-based adaptation (CBA) is emerging as a key response to this challenge. Tailored to local cultures and conditions, CBA supports and builds on autonomous adaptations to climate variability, such as the traditional baira or floating gardens of Bangladesh, which help small farmers' crops survive climate-driven floods. Above all, CBA is participatory – a process involving both local stakeholders, and development and disaster risk reduction practitioners. As such, it builds on existing cultural norms while addressing local development issues that contribute to climate vulnerability. CBA is now gaining ground in many regions, and is ripe for the reassessment offered here.

  20. Child fluorosis in Chhattisgarh, India: a community-based survey.

    Science.gov (United States)

    Vilasrao, Gitte Sunil; Kamble, K M; Sabat, Ramanath N

    2014-11-01

    To assess the prevalence and type of fluorosis among children from randomly selected villages of Chhattisgarh, and its relationship with fluoride levels in drinking water. A community based door-to-door survey was conducted in the sampled villages of seven districts of Chhattisgarh state during the year 2013-14. The field case definitions were used for labelling types of fluorosis. The fluoride concentration in drinking water was estimated by ion selective electrode method. The prevalence of fluorosis ranged between 12 to 44% in children of surveyed districts. The fluoride levels in drinking water of selected villages were in the range of 0.1-9.0 ppm. Dental and skeletal fluorosis is endemic among children in the surveyed districts of Chhattisgarh State, and is related to drinking water with fluoride content of =1.5 ppm.

  1. Variability in ADHD care in community-based pediatrics.

    Science.gov (United States)

    Epstein, Jeffery N; Kelleher, Kelly J; Baum, Rebecca; Brinkman, William B; Peugh, James; Gardner, William; Lichtenstein, Phil; Langberg, Joshua

    2014-12-01

    Although many efforts have been made to improve the quality of care delivered to children with attention-deficit/hyperactivity disorder (ADHD) in community-based pediatric settings, little is known about typical ADHD care in these settings other than rates garnered through pediatrician self-report. Rates of evidence-based ADHD care and sources of variability (practice-level, pediatrician-level, patient-level) were determined by chart reviews of a random sample of 1594 patient charts across 188 pediatricians at 50 different practices. In addition, the associations of Medicaid-status and practice setting (ie, urban, suburban, and rural) with the quality of ADHD care were examined. Parent- and teacher-rating scales were used during ADHD assessment with approximately half of patients. The use of Diagnostic and Statistical Manual of Mental Disorders criteria was documented in 70.4% of patients. The vast majority (93.4%) of patients with ADHD were receiving medication and only 13.0% were receiving psychosocial treatment. Parent- and teacher-ratings were rarely collected to monitor treatment response or side effects. Further, fewer than half (47.4%) of children prescribed medication had contact with their pediatrician within the first month of prescribing. Most variability in pediatrician-delivered ADHD care was accounted for at the patient level; however, pediatricians and practices also accounted for significant variability on specific ADHD care behaviors. There is great need to improve the quality of ADHD care received by children in community-based pediatric settings. Improvements will likely require systematic interventions at the practice and policy levels to promote change. Copyright © 2014 by the American Academy of Pediatrics.

  2. Examining the evidence of under-five mortality reduction in a community-based programme in Gaza, Mozambique.

    Science.gov (United States)

    Edward, Anbrasi; Ernst, Pieter; Taylor, Carl; Becker, Stan; Mazive, Elisio; Perry, Henry

    2007-08-01

    Effective implementation of programmes with the community Integrated Management of Childhood Illness model has demonstrated improvements in care-seeking behaviours and utilisation of health services. The child survival programme implemented in Chokwe district of Gaza province, Mozambique, achieved high coverage for bed net use (80%), oral rehydration therapy for children with diarrhoea (94%) and prompt care-seeking from trained providers for children with danger signs. The project also instituted a community-based vital registration and health information system for routine surveillance of births, deaths and childhood illnesses using an extensive network of 2300 volunteers. Evidence from this system indicated a 66% reduction in infant mortality and a 62% reduction in under-five mortality. To check the reliability of the findings, an independent mortality assessment was carried out using a pregnancy history questionnaire with a sample population of 998 women using standard methodologies applied in the Demographic and Health Surveys. The mortality survey showed reductions of 49% and 42% in infant and under-five mortality, respectively. The leading causes of death identified by verbal autopsies were malaria (30%), neonatal causes (17%) and pneumonia (21.3%). These findings suggest that effective community-based partnerships that support the delivery of health services can contribute to mortality reductions.

  3. at birth, at a birth, by birth, from birth, of... birth与give birth to

    Institute of Scientific and Technical Information of China (English)

    昝亚娟

    2000-01-01

    birth是中学英语教材中的一个常用词,也常见于birthday(生日)、birthplace(出生地)、birthrate(出生率)和birth control(计划生育)等一些复合名词或短语之中。从字面看,这些复合词和短语的意义容易理解,但下面一些含birth的介词短语和动词短语对于中学生来说就不那么容易理解了。

  4. The Healthy Lifestyle Change Program: a pilot of a community-based health promotion intervention for adults with developmental disabilities.

    Science.gov (United States)

    Bazzano, Alicia T; Zeldin, Ari S; Diab, Ida R Shihady; Garro, Nicole M; Allevato, Nathalia A; Lehrer, Danise

    2009-12-01

    Although adults with developmental disabilities are at high risk for obesity and its sequelae, few community-based lifestyle interventions targeting those with developmental disabilities exist. The study was a single group, community-based demonstration project with pre-post test evaluation conducted from December 2005 to June 2006. Eligible participants were 431 community-dwelling adults with developmental disabilities, aged 18-65 years, who were overweight/obese (BMI > or =25) with another risk factor for diabetes or metabolic syndrome or who had a diagnosis of diabetes, and received services from a community agency. Eighty-five signed up (20% of those eligible), 68 participated in an initial class, and 44 completed the program (35% attrition rate). The Healthy Lifestyle Change Program (HLCP) is a community-based health intervention developed and implemented using community-based participatory research methods by members of the developmental disabilities community, in collaboration with academic researchers. The HLCP was a 7-month, twice-weekly education and exercise program to increase knowledge, skills, and self-efficacy regarding health, nutrition, and fitness among adults with developmental disabilities. Peer mentors served as participant leaders and primary motivators. Changes in weight, BMI, abdominal girth, access to care, and self-reported nutrition, physical activity, and life satisfaction were each measured. Two thirds of participants maintained or lost weight, with a mean weight loss of 2.6 pounds and a median weight loss of 7 lbs (range: 2-24 lbs). Average BMI decreased by 0.5 kg/m(2) (p=0.04). Abdominal girth decreased in 74% of participants (mean= -1.9 inches). Sixty-one percent of participants reported increased physical activity. Mean exercise frequency increased from 3.2 times to 3.9 times per week (p=0.01). Mean exercise duration increased from 133 minutes to 206.4 minutes per week (p=0.02). Significant improvements in nutritional habits and

  5. Helping mothers survive bleeding after birth

    DEFF Research Database (Denmark)

    Nelissen, Ellen; Ersdal, Hege; Ostergaard, Doris

    2014-01-01

    OBJECTIVE: To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. DESIGN: Educational intervention study. SETTING: Rural referral hospital in Northern Tanzania. POPULATION: Clinicians, nurse-midwives, medical attendants, and ambul......OBJECTIVE: To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. DESIGN: Educational intervention study. SETTING: Rural referral hospital in Northern Tanzania. POPULATION: Clinicians, nurse-midwives, medical attendants...... and feasible, although more time should be allocated for training, and teaching materials should be translated into the local language. Knowledge, skills, and confidence of learners increased significantly immediately after training. However, overall pass rates for skills tests of learners after training were...

  6. From institutionalized birth to home birth

    Directory of Open Access Journals (Sweden)

    Clara Fróes de Oliveira Sanfelice

    2014-06-01

    Full Text Available The study aimed to describe the experiences of a group of nurse-midwives from the city of Campinas, SP, Brasil, regarding the transition process from attending institutionalized births to attending home births, in the period 2011 – 2013. The study is of the experience report type; the reflections, perceptions and challenges experienced in this process were collected using the technique of brainstorming. Content analysis, as proposed by Bardin, was used, which yielded four thematic categories: a the hospital experience; b living with obstetric violence; c returning home and d the challenges of home care. It is concluded that attending home births offers greater satisfaction to the nurses, even in the face of various obstacles, as it is possible to offer a care to the woman and new-born which covers both the concept of comprehensiveness and the current scientific recommendations.

  7. Challenges for traditional birth attendants in northern rural Honduras.

    Science.gov (United States)

    Low, Lisa Kane; Scheib, Holly; Bailey, Joanne Motino; Sacks, Emma

    2006-03-01

    to explore the relationship between community-based parteras, the staff at the Centro Materno Infantil (Mother-Child Centre), and other public health facilities within the district of Morazán in northern rural Honduras during the transition to new models of maternity care. focus-group discussions with two groups composed of a convenience sample of community parteras. After verbatim translation of the interviews, the transcripts were analysed for content. the Centro de Salud of Morazán, Yoro Honduras. 28 community-based parteras and one partero (male community midwife). five themes emerged from the focus group data: the shared view that attending birth is connected to a religious calling; the desire for additional training; the desire for support from, and connection to, existing public-health services and infrastructure; the role of parteras in providing services to women who otherwise would not receive care; and the lack of new parteras to carry on this work in the future. traditional birth attendants are still relied upon to serve more than half of the childbearing women in Honduras. The findings from the focus groups provide a foundation upon which to strengthen the relationship between community-based parteras and the government-funded systems of health care during this time of transition to new models of maternity care.

  8. Developing a culturally appropriate preconception health promotion strategy for newly immigrated Latinos through a community-based program in South Carolina.

    Science.gov (United States)

    Torres, Myriam E; Smithwick-Leone, Julie; Willms, Lucy; Franco, Margarita M; McCandless, Romina; Lohman, Mary

    2013-01-01

    Maternal and Child Health (MCH) experts emphasize the importance of preconception health (PCH) in achieving healthy pregnancies and positive birth outcomes. Research demonstrates that Latinas face significant PCH disparities, yet no comprehensive PCH promotion strategy exists to reach them. As a trusted community-based organization that uses culturally competent strategies to promote MCH in the Latino community, PASOs is well-positioned to address PCH among Latinos in South Carolina. With the input and support of Latino community members, PASOs is pioneering a PCH strategy using its successful model of education, outreach, partnerships and resource navigation.

  9. Strategies for Meaningful Engagement between Community-Based Health Researchers and First Nations Participants

    Directory of Open Access Journals (Sweden)

    Jaime Cidro

    2017-06-01

    Full Text Available The Baby Teeth Talk Study (BTT is a partnership-based research project looking at interventions to prevent early childhood caries (ECC in First Nations populations in Canada. Community-based researchers (CBRs conducted preventive and behavioral interventions that targeted expectant mothers and their newborns, over a 3-year period. The work of the CBRs requires a great deal of training and skills to administer the interventions. It also requires a broad set of strategies to meaningfully engage participants to make health-promoting changes in their behavior to prevent ECC in their children. After implementing the intervention, BTT CBRs participated in interviews to explore the strategies they employed to engage participants in the prevention of ECC. CBRs perceived two key strategies as essential for meaningful engagement with BTT participants. First, CBRs indicated that their shared experiences through motherhood, First Nations identity, age, and childhood experience provided a positive foundation for dialog with participants that lead to build trust and rapport. Second, supportive interpersonal and culturally based communication skills of the CBR provided further foundation to engage with participants from a strength-based approach. For example, the CBRs knew how to effectively communicate in ways such as being gentle, non-intrusive, and avoiding any perception of judgment when discussing oral health behavior. In First Nations health research, CBRs can provide an essential link in engaging participants and the community for improvements in health. Researchers should carefully consider characteristics such as shared experience and ability to understand cultural communication styles when hiring CBRs in order to build a solid foundation of trust with research participants.

  10. Community-based care of children with HIV in Potchefstroom, South Africa.

    Science.gov (United States)

    Van Graan, Anneke; Van der Walt, Engela; Watson, Mada

    2007-11-01

    Children contract HIV infection largely through vertical transmission and are vulnerable to AIDS illness due to an immature immune system. In South Africa, hospitals are often overburdened and thus children with HIV may be directed to the community for care. As a result, non-professional caregivers are a predominant source of care for children living with HIV. Various authors, including the Department of Health, have stipulated the importance of establishing the knowledge and needs of non-professional caregivers of children with HIV. Our research has investigated the extent of non-professional caregivers' knowledge and needs, specifically those within the Potchefstroom district of the North-West Province. The objectives included formulating guidelines for a training programme that can enhance relevant knowledge and skills among these caregivers. Quantitative data were gathered using a questionnaire, which was developed following a literature study. The 109 non-professional caregivers who responded to the questionnaire displayed some knowledge and skills concerning specifically the care of children with HIV or AIDS, although gaps existed concerning their knowledge of community-based referral, caring needs specific to children, and precautionary measures to prevent HIV transmission. Recommendations are made with specific reference to a training programme. We surmise that non-professional caregivers play a pivotal role in the care of children with HIV in the Potchefstroom district - a service that is sometimes rendered in perilous conditions. This study improves our understanding of the support and training needed for non-professional caregivers in their pursuit to care for children with HIV in resource-limited communities, and thus it contributes to the field of nursing science. The findings may generate ideas for future research on this important topic.

  11. A systematic review of the effectiveness of alternative cadres in community based rehabilitation

    Directory of Open Access Journals (Sweden)

    Mannan Hasheem

    2012-08-01

    Full Text Available Abstract Background The Millennium Development Goals (MDGs aim to improve population health and the quality and dignity of people’s lives, but their achievement is constrained by the crisis in human resources for health. An important potential contribution towards achieving the MDGs for persons with disabilities will be the newly developed Guidelines for Community Based Rehabilitation (CBR, launched in 2010. Given the global shortage of medical and nursing personnel and highly skilled rehabilitation practitioners, effective implementation of the CBR guidelines will require additional health workers, with improved distribution and a new skill set, allowing them to work across the health, education, livelihoods, social, and development sectors. Methods We conducted a systematic review to evaluate existing evidence regarding the effectiveness of alternative cadres working in CBR in low and middle income countries. We searched the following databases: PUBMED, LILACS, SCIE, ISMEAR, WHOLIS, AFRICAN MED IND. We also searched the online archive of the Asia Pacific Disability Rehabilitation Journal (available from 2002 to 2010, which was not covered by any of the other databases. There was no limit set on inclusion with regard to how recent a publication was in the general search. Results The search yielded 235 abstracts, only 6 of which addressed CBR through some type of evaluative component. Three of the studies explored the effects of CBR interventions, mainly related to physical disabilities, while three explored issues concerned with the work performance of rehabilitation workers. Altogether the studies covered four different countries. Conclusion All six studies related to specific service delivery in local contexts, using outcome measures that were not comparable across studies. We do not, therefore, feel that the current results provide adequate methodology or evidence for reliably generalizing their results. Due to the dearth of evidence

  12. Effectiveness of a community-based advocacy and learning program for hmong refugees.

    Science.gov (United States)

    Goodkind, Jessica R

    2005-12-01

    The effectiveness of a community-based advocacy and learning intervention for Hmong refugees was assessed using a comprehensive, multi-method strategy, which included a within-group longitudinal design with four data collection points and in-depth qualitative recruitment and post-intervention interviews. The intervention's impact on five aspects of refugee well-being was examined: Participants' psychological well-being, quality of life, access to resources, English proficiency, and knowledge for the U.S. citizenship exam. Twenty-eight Hmong adults and 27 undergraduate students participated together in the intervention, which had two major components: (1) Learning Circles, which involved cultural exchange and one-on-one learning opportunities for Hmong adults, and (2) an advocacy component that involved undergraduates advocating for and transferring advocacy skills to Hmong families to increase their access to resources in their communities. Undergraduate paraprofessionals and Hmong participants worked together for 6-8 hr per week for 6 months. Growth trajectory analysis revealed promising quantitative findings. Participants' quality of life, satisfaction with resources, English proficiency, and knowledge for the U.S. citizenship test increased and their levels of distress decreased over the course of the intervention. Mediating analyses suggested that participants' increased quality of life could be explained by their improved satisfaction with resources. Qualitative data helped to support and explain the quantitative data, as well as providing insight into other outcomes and processes of the intervention. Policy, practice, and research implications are discussed.

  13. Community-based interventions for obesity prevention: lessons learned by Australian policy-makers.

    Science.gov (United States)

    Haby, Michelle M; Doherty, Rebecca; Welch, Nicky; Mason, Vicky

    2012-01-10

    Interest in community-based interventions (CBIs) for health promotion is increasing, with a lot of recent activity in the field. This paper aims, from a state government perspective, to examine the experience of funding and managing six obesity prevention CBIs, to identify lessons learned and to consider the implications for future investment. Specifically, we focus on the planning, government support, evaluation, research and workforce development required. The lessons presented in this paper come from analysis of key project documents, the experience of the authors in managing the projects and from feedback obtained from key program stakeholders. CBIs require careful management, including sufficient planning time and clear governance structures. Selection of interventions should be based on evidence and tailored to local needs to ensure adequate penetration in the community. Workforce and community capacity must be assessed and addressed when selecting communities. Supporting the health promotion workforce to become adequately skilled and experienced in evaluation and research is also necessary before implementation.Comprehensive evaluation of future projects is challenging on both technical and affordability grounds. Greater emphasis may be needed on process evaluation complemented by organisation-level measures of impact and monitoring of nutrition and physical activity behaviours. CBIs offer potential as one of a mix of approaches to obesity prevention. If successful approaches are to be expanded, care must be taken to incorporate lessons from existing and past projects. To do this, government must show strong leadership and work in partnership with the research community and local practitioners.

  14. Case Study Report: Community-Based Monitoring Systems for REDD+ in Guyana

    Directory of Open Access Journals (Sweden)

    Helen Bellfield

    2015-01-01

    Full Text Available A fundamental component of initiatives to reduce emissions from deforestation and forest degradation (REDD+; will be the development of robust and cost-effective measuring, reporting, and verification (MRV instruments for national forest monitoring and safeguard information systems. It is increasingly recognized that community-based monitoring (CBM offers a positive model for greater participation and engagement of indigenous and forest-dependent communities within a REDD+ framework. Yet plans for CBM within REDD+ MRV systems remain limited, and there are currently relatively few concrete examples of CBM informing national forest monitoring systems. This paper outlines findings from a community MRV project with Amerindian communities in the North Rupununi, Guyana; and demonstrates that a CBM approach can enable key REDD+ requirements: in understanding local deforestation drivers and measuring carbon stocks; and for providing information on safeguards through social and environmental assessments. In addition, the authors discuss community capacity-building on smartphone technology for monitoring as a challenging yet viable pathway for scaling the use and adoption of indigenous knowledge and local skills for REDD+ programs.

  15. Supervising dentists' perspectives on the effectiveness of community-based dental education.

    Science.gov (United States)

    Nayar, Preethy; McFarland, Kimberly; Lange, Brian; Ojha, Diptee; Chandak, Aastha

    2014-08-01

    The Commission on Dental Accreditation recently implemented new predoctoral standards that require dental schools in the United States to provide students with community-based dental education (CBDE) experiences. The objective of this study was to examine the perspectives of supervising dentists (also known as dental preceptors) at rural CBDE sites regarding the University of Nebraska Medical Center program's effectiveness in improving the competencies of dental students. Surveys were sent to all forty-three preceptors in two subsequent years: nineteen responded to all questions in 2012 and sixteen in 2013, for a total of thirty-five participants. These preceptors evaluated the effectiveness of the program based on the American Dental Education Association (ADEA) Competencies for the New General Dentist. Overall, these preceptors rated the CBDE program as effective (excellent or very good) in improving the students' competence in five of the six ADEA domains: Critical Thinking, Professionalism, Communication and Interpersonal Skills, Health Promotion, Patient Care: Assessment, Diagnosis, and Treatment Planning, and Patient Care: Establishment and Maintenance of Oral Health. Practice Management and Informatics was found to be the least effective domain of competence. CBDE provides a unique opportunity to develop a competent dental workforce with an appreciation for the value of community service. Applying a competency-based framework to program evaluation can provide valuable information on program effectiveness to program administrators, educators, and the dental preceptors.

  16. Implementation and evaluation of a community-based interprofessional learning activity.

    Science.gov (United States)

    Luebbers, Ellen L; Dolansky, Mary A; Vehovec, Anton; Petty, Gayle

    2017-01-01

    Implementation of large-scale, meaningful interprofessional learning activities for pre-licensure students has significant barriers and requires novel approaches to ensure success. To accomplish this goal, faculty at Case Western Reserve University, Ohio, USA, used the Ottawa Model of Research Use (OMRU) framework to create, improve, and sustain a community-based interprofessional learning activity for large numbers of medical students (N = 177) and nursing students (N = 154). The model guided the process and included identification of context-specific barriers and facilitators, continual monitoring and improvement using data, and evaluation of student learning outcomes as well as programme outcomes. First year Case Western Reserve University medical students and undergraduate nursing students participated in team-structured prevention screening clinics in the Cleveland Metropolitan Public School District. Identification of barriers and facilitators assisted with overcoming logistic and scheduling issues, large class size, differing ages and skill levels of students and creating sustainability. Continual monitoring led to three distinct phases of improvement and resulted in the creation of an authentic team structure, role clarification, and relevance for students. Evaluation of student learning included both qualitative and quantitative methods, resulting in statistically significant findings and qualitative themes of learner outcomes. The OMRU implementation model provided a useful framework for successful implementation resulting in a sustainable interprofessional learning activity.

  17. "Razoo Health:" A Community-Based Nursing Education Initiative.

    Science.gov (United States)

    Kraus, Marjorie B.; Morgan, Connie M.; Matteson, Peggy S.

    2003-01-01

    In New Orleans, nursing faculty and students partnered with inner-city schools and churches to mobilize neighborhood assets and improve health care. Students learned community assessment skills and worked with empowered citizens who reclaimed their health resources. (Contains 28 references.) (SK)

  18. Politics, power, and birth.

    Science.gov (United States)

    Tillett, Jackie

    2011-01-01

    Politics is the process and method of decision making for individuals and groups. Politics may define the power relationships between women and their healthcare providers. Politics may shape the experience for the woman. Nurses and birthing women can learn to negotiate the politics and power relationships surrounding the birth experience.

  19. Labor and Birth

    Science.gov (United States)

    ... pushing your baby down and out of the birth canal. In other words, labor pain has a purpose. Try the following to help ... Opioids don't get rid of all the pain, and they are short-acting. They can make ... birth. Epidural and spinal blocks – An epidural involves placing ...

  20. Data Publication: The Role of Community-Based, Disciplinary Repositories

    Science.gov (United States)

    Lehnert, Kerstin; Hsu, Leslie

    2013-04-01

    Data publication is increasingly recognized as a new paradigm to achieve broad and open access to data for their re-use while ensuring proper citation and attribution of the data to their creator. Current models of data publication include special data journals, institutional repositories, and programmatic or disciplinary repositories. This presentation focuses on the critical role that community-based disciplinary repositories should play, using the example of the IEDA data facility (www.iedadata.org). Disciplinary repositories ensure that data publication is successfully implemented and adopted by the science community, so that it can fulfill its promise to advance data reuse, enhance reproducibility of scientific results, and offer new opportunities for scientific discoveries. Disciplinary repositories are ideally poised to address the challenges that can lead to 'data reuse failure' (Rees 2010), which in turn obstruct the successful development and implementation of new data infrastructures for the sciences. Among these challenges are: professional motivation for investigators to publish the data; effort and economic burden of publication; discovery and long-term accessibility of data; adequate documentation of data provenance (measured parameters, uncertainty, reproducibility, materials, methods, data manipulation); and usability (file formats, interfaces to software tools for data analysis, visualization, modeling). The relevant function of a disciplinary repository is to coordinate and bridge the needs of its community with recognized requirements for data curation and demands of evolving technologies. IEDA meets that function, gathering regular guidance from the community, developing community-approved best practices and guidelines; providing guidance and tools to investigators that facilitate the process of data publication; and performing data quality control. IEDA's sustainable infrastructure supports the discovery and access of the data, and IEDA

  1. Perceptions of Social Support from Pregnant and Parenting Teens Using Community-Based Doulas

    OpenAIRE

    Breedlove, Ginger

    2005-01-01

    Few studies have examined community-based doula care during the childbearing period. This descriptive study was designed to explore and describe the perceptions of disadvantaged pregnant and parenting teens (N = 24) who received support from culturally matched, community-based doulas. Their reported perceptions included enhanced knowledge about childbearing, support during childbirth, self-care, and early attachment to the newborn. Participants concurred that the community-based doula interve...

  2. Narcissism and birth order.

    Science.gov (United States)

    Eyring, W E; Sobelman, S

    1996-04-01

    The purpose of this investigation was to clarify the relationship between birth-order position and the development of narcissism, while refining research and theory. The relationship between birth-order status and narcissism was examined with a sample of 79 undergraduate students (55 women and 24 men). These subjects were placed in one of the four following birth-order categories of firstborn, second-born, last-born, and only children. These categories were chosen given their significance in Adlerian theory. Each subject completed the Narcissistic Personality Inventory and a demographic inventory. Based on psychodynamic theory, it was hypothesized that firstborn children were expected to score highest, but statistical significance was not found for an association between narcissism and birth order. Further research is urged to investigate personality theory as it relates to parenting style and birth order.

  3. A large cross-sectional community-based study of newborn care practices in southern Tanzania.

    Directory of Open Access Journals (Sweden)

    Suzanne Penfold

    Full Text Available Despite recent improvements in child survival in sub-Saharan Africa, neonatal mortality rates remain largely unchanged. This study aimed to determine the frequency of delivery and newborn-care practices in southern Tanzania, where neonatal mortality is higher than the national average. All households in five districts of Southern Tanzania were approached to participate. Of 213,220 female residents aged 13-49 years, 92% participated. Cross-sectional, retrospective data on childbirth and newborn care practices were collected from 22,243 female respondents who had delivered a live baby in the preceding year. Health facility deliveries accounted for 41% of births, with nearly all non-facility deliveries occurring at home (57% of deliveries. Skilled attendants assisted 40% of births. Over half of women reported drying the baby and over a third reported wrapping the baby within 5 minutes of delivery. The majority of mothers delivering at home reported that they had made preparations for delivery, including buying soap (84% and preparing a cloth for drying the child (85%. Although 95% of these women reported that the cord was cut with a clean razor blade, only half reported that it was tied with a clean thread. Furthermore, out of all respondents 10% reported that their baby was dipped in cold water immediately after delivery, around two-thirds reported bathing their babies within 6 hours of delivery, and 28% reported putting something on the cord to help it dry. Skin-to-skin contact between mother and baby after delivery was rarely practiced. Although 83% of women breastfed within 24 hours of delivery, only 18% did so within an hour. Fewer than half of women exclusively breastfed in the three days after delivery. The findings suggest a need to promote and facilitate health facility deliveries, hygienic delivery practices for home births, delayed bathing and immediate and exclusive breastfeeding in Southern Tanzania to improve newborn health.

  4. Community-based distributive medical education: Advantaging society

    Directory of Open Access Journals (Sweden)

    Tracy J. Farnsworth

    2012-02-01

    Full Text Available This paper presents a narrative summary of an increasingly important trend in medical education by addressing the merits of community-based distributive medical education (CBDME. This is a relatively new and compelling model for teaching and training physicians in a manner that may better meet societal needs and expectations. Issues and trends regarding the growing shortage and imbalanced distribution of physicians in the USA are addressed, including the role of international medical graduates. A historical overview of costs and funding sources for medical education is presented, as well as initiatives to increase the training and placement of physicians cost-effectively through new and expanded medical schools, two- and four-year regional or branch campuses and CBDME. Our research confirms that although medical schools have responded to Association of American Medical Colleges calls for higher student enrollment and societal concerns about the distribution and placement of physicians, significant opportunities for improvement remain. Finally, the authors recommend further research be conducted to guide policy on incentives for physicians to locate in underserved communities, and determine the cost-effectiveness of the CBDME model in both the near and long terms.

  5. Community-Based Ecotourism: The Transformation of Local Community

    Directory of Open Access Journals (Sweden)

    Pookhao Nantira

    2014-01-01

    Full Text Available Community-based ecotourism (CBET is considered a sustainable form of tourism that improves the quality of life of hosts at the tourist destination. Scholars have yet to explore the long-term operation of CBET in relation to its effects on the local way of life. Consequently, the purpose of this paper is to examine the transformation of a local community due to the operation of CBET in relation to sociocultural, economic and environmental aspects. The findings reveal that the community encounters both positive and negative impacts of transformation. However, unintended impacts of the CBET operation lay embedded in the transformation of relationships among the community members. The study identifies that close relationships among the villagers has been initially transformed to loose relationships due to forgotten communal goals; CBET has transformed from being a conservation tool to being a business-oriented goal which causes conflicts of interest among local people and alters traditional social structure. The study also agrees with the notion of social exchange theory for villagers to enhance environmental sustainability, and proposes that slight inequalities of benefits received from CBET causes social transformation at the local level.

  6. SPATIAL AND ARCHITECTURAL DESIGN ASPECTS IN COMMUNITY BASED MOSQUES

    Directory of Open Access Journals (Sweden)

    Luluk Maslucha

    2012-12-01

    Full Text Available Indonesia as one of the biggest Muslim countries in the world are very rich in the quality and quantity ofmosques architecture. The largest number of mosques in Indonesia is designed, built, and developed by localcommunities. Unfortunately, the potention of these kind of mosques is often unconsciously forgotten in thefield of architectural studies. Therefore, this research is held to define these mosques’ spatial andarchitectural design aspects which were considered as appropriate for the needs of their local communities’.As a descriptive-qualitative architectural research, the methods employed in this research are (1 fieldsurveying, (2 architectural documenting, and (3 informal interview, which were held in three purposivesample of mosques: Masjid An-Nur Jagalan, Masjid Gading Pesantren, and Masjid Jami’ Kauman Malang. Thesethree mosques were chosen because of their close relations with their surrounding communities and their longtime developments by their local societies. The result of this study shows that some specific spatial andarchitectural elements which were found in these community based mosques are (1 the scale, size, and depthof space, (2 the classification and the placement of space, (3 the architectural expressions, (4 the openness,the boundaries, and the relationship between spaces, (5 the athmospherical qualities of space, (6 theclassification of the users in spaces, (7 the intensity of the users in spaces, and (8 the manner and theposition of the users in spaces.

  7. Restricted grouper reproductive migrations support community-based management

    KAUST Repository

    Waldie, Peter A.

    2016-03-09

    Conservation commonly requires trade-offs between social and ecological goals. For tropical small-scale fisheries, spatial scales of socially appropriate management are generally small—the median no-take locally managed marine area (LMMA) area throughout the Pacific is less than 1 km2. This is of particular concern for large coral reef fishes, such as many species of grouper, which migrate to aggregations to spawn. Current data suggest that the catchment areas (i.e. total area from which individuals are drawn) of such aggregations are at spatial scales that preclude effective community-based management with no-take LMMAs. We used acoustic telemetry and tag-returns to examine reproductive migrations and catchment areas of the grouper Epinephelus fuscoguttatus at a spawning aggregation in Papua New Guinea. Protection of the resultant catchment area of approximately 16 km2 using a no-take LMMA is socially untenable here and throughout much of the Pacific region. However, we found that spawning migrations were skewed towards shorter distances. Consequently, expanding the current 0.2 km2 no-take LMMA to 1–2 km2 would protect approximately 30–50% of the spawning population throughout the non-spawning season. Contrasting with current knowledge, our results demonstrate that species with moderate reproductive migrations can be managed at scales congruous with spatially restricted management tools.

  8. A Community Based Systems Diagram of Obesity Causes.

    Directory of Open Access Journals (Sweden)

    Steven Allender

    Full Text Available Application of system thinking to the development, implementation and evaluation of childhood obesity prevention efforts represents the cutting edge of community-based prevention. We report on an approach to developing a system oriented community perspective on the causes of obesity.Group model building sessions were conducted in a rural Australian community to address increasing childhood obesity. Stakeholders (n = 12 built a community model that progressed from connection circles to causal loop diagrams using scripts from the system dynamics literature. Participants began this work in identifying change over time in causes and effects of childhood obesity within their community. The initial causal loop diagram was then reviewed and elaborated by 50 community leaders over a full day session.The process created a causal loop diagram representing community perceptions of determinants and causes of obesity. The causal loop diagram can be broken down into four separate domains; social influences; fast food and junk food; participation in sport; and general physical activity.This causal loop diagram can provide the basis for community led planning of a prevention response that engages with multiple levels of existing settings and systems.

  9. Restricted grouper reproductive migrations support community-based management.

    Science.gov (United States)

    Waldie, Peter A; Almany, Glenn R; Sinclair-Taylor, Tane H; Hamilton, Richard J; Potuku, Tapas; Priest, Mark A; Rhodes, Kevin L; Robinson, Jan; Cinner, Joshua E; Berumen, Michael L

    2016-03-01

    Conservation commonly requires trade-offs between social and ecological goals. For tropical small-scale fisheries, spatial scales of socially appropriate management are generally small-the median no-take locally managed marine area (LMMA) area throughout the Pacific is less than 1 km(2). This is of particular concern for large coral reef fishes, such as many species of grouper, which migrate to aggregations to spawn. Current data suggest that the catchment areas (i.e. total area from which individuals are drawn) of such aggregations are at spatial scales that preclude effective community-based management with no-take LMMAs. We used acoustic telemetry and tag-returns to examine reproductive migrations and catchment areas of the grouper Epinephelus fuscoguttatus at a spawning aggregation in Papua New Guinea. Protection of the resultant catchment area of approximately 16 km(2) using a no-take LMMA is socially untenable here and throughout much of the Pacific region. However, we found that spawning migrations were skewed towards shorter distances. Consequently, expanding the current 0.2 km(2) no-take LMMA to 1-2 km(2) would protect approximately 30-50% of the spawning population throughout the non-spawning season. Contrasting with current knowledge, our results demonstrate that species with moderate reproductive migrations can be managed at scales congruous with spatially restricted management tools.

  10. A Community Based Systems Diagram of Obesity Causes.

    Science.gov (United States)

    Allender, Steven; Owen, Brynle; Kuhlberg, Jill; Lowe, Janette; Nagorcka-Smith, Phoebe; Whelan, Jill; Bell, Colin

    2015-01-01

    Application of system thinking to the development, implementation and evaluation of childhood obesity prevention efforts represents the cutting edge of community-based prevention. We report on an approach to developing a system oriented community perspective on the causes of obesity. Group model building sessions were conducted in a rural Australian community to address increasing childhood obesity. Stakeholders (n = 12) built a community model that progressed from connection circles to causal loop diagrams using scripts from the system dynamics literature. Participants began this work in identifying change over time in causes and effects of childhood obesity within their community. The initial causal loop diagram was then reviewed and elaborated by 50 community leaders over a full day session. The process created a causal loop diagram representing community perceptions of determinants and causes of obesity. The causal loop diagram can be broken down into four separate domains; social influences; fast food and junk food; participation in sport; and general physical activity. This causal loop diagram can provide the basis for community led planning of a prevention response that engages with multiple levels of existing settings and systems.

  11. Potential for Integrating Community-Based Monitoring into REDD+

    Directory of Open Access Journals (Sweden)

    Arturo Balderas Torres

    2014-07-01

    Full Text Available Countries at the United Nations Framework on the Convention on Climate Change (UNFCCC have decided to engage local communities and indigenous groups into the activities for the monitoring, reporting and verification (MRV of the program to reduce emissions from deforestation and forest degradation and increase carbon removals (REDD+. Previous research and projects have shown that communities can produce reliable data on forest area and carbon estimates through field measurements. The objective of this article is to describe the framework that is being created for REDD+ under the UNFCCC to identify the potential inclusion of local information produced through community-based monitoring (CBM into monitoring systems for REDD+. National systems could use different sources of information from CBM: first, local information can be produced as part of public programs by increasing sample size of national or regional inventories; second, government can collect information to produce carbon estimates from on-going management practices implemented at local level driven by access to local direct benefits (e.g., forest management plans, watershed conservation; third, national data systems could include information from projects participating in carbon markets and other certification schemes; and finally information will be produced as part of the activities associated to the implementation of social and environmental safeguards. Locally generated data on carbon and areas under different forms of management can be dovetailed into national systems and be used to describe management practices, complement existing information or replace Tier 1/2 values with more detailed local data produced by CBM.

  12. Enhancing Community-Based Participatory Research Partnerships Through Appreciative Inquiry.

    Science.gov (United States)

    Paige, Ciara; Peters, Ruth; Parkhurst, Malia; Beck, Leah Leilani; Hui, Brian; May, Vanessa Tui; Tanjasiri, Sora Park

    2015-01-01

    Challenges in community-based participatory research (CBPR) partnerships often pertain to trust and power, dilemmas posed by funding sources, and equitable community participation. Although challenges in CBPR can be welcomed because they present opportunities for growth and development of partnerships, tools are needed to facilitate issue identification and resolution. Moreover, such tools need to align with CBPR principles involving equal feedback among partners to improve the partnership and its outcomes. To describe how appreciative inquiry (AI) was used as an evaluation tool to contribute to the strengthening of empowerment of ongoing and future community-university relationships in CBPR collaborations. AI was applied at the end of a community-university partnership to promote breast and cervical cancer screening among Tongan women in Southern California. Through individual interviews and group discussion, tensions were identified and discussed in light of partnership and community strengths. Through AI, program staff emphasized community and university strengths of shared key values related to the program and aspects of program management that enabled them to contribute to successful program outcomes. They also discussed the following challenges: 1) approach of partners, 2) role definition, and 3) and time span of program development and implementation. Based on these discussions, recommendations were made to overcome current challenges and improve ongoing and future CBPR collaborations. The AI process helped the partners recommit to collaborate with each other, renewed their excitement about working together, and assisted with reclarification of their roles to inform future collaborations.

  13. Community based mangrove management: a review on status and sustainability.

    Science.gov (United States)

    Datta, Debajit; Chattopadhyay, R N; Guha, P

    2012-09-30

    Community Based Mangrove Management (CBMM) has been advocated by both academia and governing agencies as a viable alternative for sustainably managing the ecologically important mangrove forests which are disappearing rapidly worldwide. Drawing insights from diverse sustainability issues, capabilities and performances of worldwide CBMM initiatives were examined in this paper. Higher numbers of CBMM initiatives were reported from South Asia and lesser from South America and Africa. Identification of the causes of degradation at a site and use-specific zonal replantations with respect to species associations were identified as major criteria of ecological sustainability. Regarding economic sustainability, transformation of potential uses of mangroves known by local communities into actual ones was found to be necessary. Proper disbursement of accrued benefits among community members irrespective of their socio-cultural status is also a major concern. Restructuring of CBMM institutions by ensuring participation of subsistence based users in decision-making and resource sharing have been identified as a prime determinant of institutional sustainability. However, limited number of studies on socio-political and institutional aspects as well as impacts of globalization induced socio-cultural transformations of communities on CBMM had been actually found. More focused researches on these aspects had been recommended for better community management of these highly stressed forests.

  14. Developing a theoretical framework for complex community-based interventions.

    Science.gov (United States)

    Angeles, Ricardo N; Dolovich, Lisa; Kaczorowski, Janusz; Thabane, Lehana

    2014-01-01

    Applying existing theories to research, in the form of a theoretical framework, is necessary to advance knowledge from what is already known toward the next steps to be taken. This article proposes a guide on how to develop a theoretical framework for complex community-based interventions using the Cardiovascular Health Awareness Program as an example. Developing a theoretical framework starts with identifying the intervention's essential elements. Subsequent steps include the following: (a) identifying and defining the different variables (independent, dependent, mediating/intervening, moderating, and control); (b) postulating mechanisms how the independent variables will lead to the dependent variables; (c) identifying existing theoretical models supporting the theoretical framework under development; (d) scripting the theoretical framework into a figure or sets of statements as a series of hypotheses, if/then logic statements, or a visual model; (e) content and face validation of the theoretical framework; and (f) revising the theoretical framework. In our example, we combined the "diffusion of innovation theory" and the "health belief model" to develop our framework. Using the Cardiovascular Health Awareness Program as the model, we demonstrated a stepwise process of developing a theoretical framework. The challenges encountered are described, and an overview of the strategies employed to overcome these challenges is presented.

  15. Community Health Workers Support Community-based Participatory Research Ethics:

    Science.gov (United States)

    Smith, Selina A.; Blumenthal, Daniel S.

    2013-01-01

    Ethical principles of community-based participatory research (CBPR)— specifically, community engagement, mutual learning, action-reflection, and commitment to sustainability—stem from the work of Kurt Lewin and Paulo Freire. These are particularly relevant in cancer disparities research because vulnerable populations are often construed to be powerless, supposedly benefiting from programs over which they have no control. The long history of exploiting minority individuals and communities for research purposes (the U.S. Public Health Service Tuskegee Syphilis Study being the most notorious) has left a legacy of mistrust of research and researchers. The purpose of this article is to examine experiences and lessons learned from community health workers (CHWs) in the 10-year translation of an educational intervention in the research-to-practice-to-community continuum. We conclude that the central role played by CHWs enabled the community to gain some degree of control over the intervention and its delivery, thus operationalizing the ethical principles of CBPR. PMID:23124502

  16. Comprendiendo el community-based tourism desde la comunidad

    Directory of Open Access Journals (Sweden)

    Esteban Ruiz

    2008-01-01

    Full Text Available El creciente impulso del Community-based tourism (CBT como vía para un turismo sostenible y estrategia para el desarrollo social nos obliga a profundizar en su comprensión. En este artículo proponemos como táctica teórico-metodológica la focalización analítica en la comunidad. El referente empírico de la investigación es el turismo comunitario (TC en Ecuador, donde se han seleccionado cinco comunidades para llevar a cabo un estudio etnográfico en profundidad. Como conclusión planteamos un marco comprensivo del TC que tiene tres pilares básicos: la centralidad analítica de las comunidades, la consideración del TC como `traducción´ antes que como `adaptación´ al mercado, y el carácter fortalecedor —antes que debilitador— del TC para las comunidades. De aquí se derivan una serie de indicadores cualitativos que sirven para encarar, desde el punto de vista teórico, la comprensión general del CBT y asimismo son útiles para la evaluación de la sostenibilidad de proyectos y experiencias de CBT

  17. Community-based livestock breeding programmes: essentials and examples.

    Science.gov (United States)

    Mueller, J P; Rischkowsky, B; Haile, A; Philipsson, J; Mwai, O; Besbes, B; Valle Zárate, A; Tibbo, M; Mirkena, T; Duguma, G; Sölkner, J; Wurzinger, M

    2015-04-01

    Breeding programmes described as community-based (CBBP) typically relate to low-input systems with farmers having a common interest to improve and share their genetic resources. CBBPs are more frequent with keepers of small ruminants, in particular smallholders of local breeds, than with cattle, pigs or chickens with which farmers may have easier access to alternative programmes. Constraints that limit the adoption of conventional breeding technologies in low-input systems cover a range of organizational and technical aspects. The analysis of 8 CBBPs located in countries of Latin-America, Africa and Asia highlights the importance of bottom-up approaches and involvement of local institutions in the planning and implementation stages. The analysis also reveals a high dependence of these programmes on organizational, technical and financial support. Completely self-sustained CBBPs seem to be difficult to realize. There is a need to implement and document formal socio-economic evaluations of CBBPs to provide governments and other development agencies with the information necessary for creating sustainable CBBPs at larger scales.

  18. Unintended Pregnancy in Ethiopia: Community Based Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Kidest Getu Melese

    2016-01-01

    Full Text Available Introduction. Unintended pregnancy is defined as a pregnancy which is a sum of mistimed pregnancy (pregnancy wanted at a later time and unwanted pregnancy (pregnancy which is not wanted at all. Unintended pregnancy is a global public health problem and its sequels are major causes for maternal and neonatal morbidity and mortality with its effect to maternal metal illness as well. Objective. To determine the prevalence and associated factors of unintended pregnancy in Debre Birhan town, northeast of Ethiopia, in 2014. Method. Community based cross-sectional study and questionnaire developed from Ethiopian demographic health survey 2011. Participants were 690 currently pregnant mothers. Association of unintended pregnancy with factors was measured with bivariate and multivariate logistic regressions. Result. In this study unintended pregnancy is found to be 23.5%. Being formerly married and never married, distance to the nearest health facility >80 minutes, gravidity >5, 1-2 parity, and partner disagreement on desired number of children are the variables significantly associated with unintended pregnancy. Conclusion. Significant proportion of unintended pregnancy is found in the study area. To minimize unintended pregnancy concerned bodies should work on the identified factors, so we can minimize maternal and neonatal morbidity and mortality and keep the health of the family specifically and country in general.

  19. Accuracy of Birth Certificate Data for Classifying Preterm Birth.

    Science.gov (United States)

    Stout, Molly J; Macones, George A; Tuuli, Methodius G

    2017-05-01

    Classifying preterm birth as spontaneous or indicated is critical both for clinical care and research, yet the accuracy of classification based on different data sources is unclear. We examined the accuracy of preterm birth classification as spontaneous or indicated based on birth certificate data. This is a retrospective cohort study of 123 birth certificates from preterm births in Missouri. Correct classification of spontaneous or indicated preterm birth subtype was based on multi-provider (RN, MFM Fellow, MFM attending) consensus after full medical record review. A categorisation algorithm based on clinical data available in the birth certificate was designed a priori and classification was performed by a single investigator according to the algorithm. Accuracy of birth certificate classification as spontaneous or indicated was compared to the consensus classification. Errors in misclassification were explored. Classification based on birth certificates was correct for 66% of preterm births. Most errors in classification by birth certificate occurred in classifying a birth as spontaneous when it was in fact indicated. The vast majority of errors occurred when preterm rupture of membranes (≥12 h) was checked on the birth certificate causing classification as spontaneous when there was a maternal or fetal indication for delivery. Birth certificate classification overestimated spontaneous preterm birth and underestimated indicated preterm birth compared to classification performed from medical record review. Revisions to birth certificate clinical data would allow more accurate population level surveillance of preterm birth subtypes. © 2017 John Wiley & Sons Ltd.

  20. Birth control pills - progestin only

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000656.htm Birth control pills - progestin only To use the sharing ... have estrogen in them. What Are Progestin Only Birth Control Pills? Birth control pills help keep you ...

  1. Student nurses' experiences of community-based practice placement learning: a qualitative exploration.

    Science.gov (United States)

    Baglin, M R; Rugg, Sue

    2010-05-01

    United Kingdom (UK) health policy has adopted an increasing community and primary care focus over recent years (Department of Health, 1997; Department of Health, 1999. Making a Difference: Strengthening the Nursing, Midwifery and Health Visitor Contribution to Health and Health Care. Department of Health, London; Department of Health, 2004. The NHS Knowledge and Skills Framework (NHS KSF). Department of Health, London). Nursing practice, education and workforce planning are called upon to adapt accordingly (Department of Health, 2004. The NHS Knowledge and Skills Framework (NHS KSF). Department of Health, London; Kenyon, V., Smith, E., Hefty, L., Bell, M., Martaus, T., 1990. Clinical competencies for community health nursing. Public Health Nursing 7(1), 33-39; United Kingdom Central Council for Nursing, Midwifery and Health Visiting, 1986. Project 2000: A New Preparation for Practice. UKCC, London). Such changes have major implications for pre-registration nursing education, including its practice placement element. From an educational perspective, the need for increased community nursing capacity must be balanced with adequate support for student nurses' learning needs during community-based placements. This qualitative study explored six second year student nurses' experiences of 12 week community-based practice placements and the extent to which these placements were seen to meet their perceived learning needs. The data came from contemporaneous reflective diaries, completed by participants to reflect their 'lived experience' during their practice placements (Landeen, J., Byrne, Brown, B., 1995. Exploring the lived experiences of psychiatric nursing students through self-reflective journals. Journal of Advanced Nursing 21(5), 878-885; Kok, J., Chabeli, M.M., 2002. Reflective journal writing: how it promotes reflective thinking in clinical nursing education: a students' perspective. Curationis 25(3), 35-42; Löfmark, A., Wikblad, K., 2001. Facilitating and

  2. The effectiveness of community-based cycling promotion: findings from the Cycling Connecting Communities project in Sydney, Australia

    Directory of Open Access Journals (Sweden)

    Merom Dafna

    2010-01-01

    Full Text Available Abstract Background Encouraging cycling is an important way to increase physical activity in the community. The Cycling Connecting Communities (CCC Project is a community-based cycling promotion program that included a range of community engagement and social marketing activities, such as organised bike rides and events, cycling skills courses, the distribution of cycling maps of the area and coverage in the local press. The aim of the study was to assess the effectiveness of this program designed to encourage the use of newly completed off-road cycle paths through south west Sydney, Australia. Methods The evaluation used a quasi-experimental design that consisted of a pre- and post-intervention telephone survey (24 months apart of a cohort of residents (n = 909 in the intervention area (n = 520 (Fairfield and Liverpool and a socio-demographically similar comparison area (n = 389 (Bankstown. Both areas had similar bicycle infrastructure. Four bicycle counters were placed on the main bicycle paths in the intervention and comparison areas to monitor daily bicycle use before and after the intervention. Results The telephone survey results showed significantly greater awareness of the Cycling Connecting Communities project (13.5% vs 8.0%, p Conclusion Despite relatively modest resources, the Cycling Connecting Communities project achieved significant increases in bicycle path use, and increased cycling in some sub-groups. However, this community based intervention with limited funding had very limited reach into the community and did not increase population cycling levels.

  3. Translating Policy into Practice for Community-Based Management of Rheumatoid Arthritis: Targeting Professional Development Needs among Physiotherapists

    Directory of Open Access Journals (Sweden)

    Robyn E. Fary

    2012-01-01

    Full Text Available Introduction. Contemporary health policy promotes delivery of community-based health services to people with musculoskeletal conditions, including rheumatoid arthritis (RA. This emphasis requires a skilled workforce to deliver safe, effective care. We aimed to explore physiotherapy workforce readiness to co-manage consumers with RA by determining the RA-specific professional development (PD needs in relation to work and educational characteristics of physiotherapists in Western Australia (WA. Methods. An e-survey was sent to physiotherapists regarding their confidence in co-managing people with RA and their PD needs. Data including years of clinical experience, current RA clinical caseload, professional qualifications, and primary clinical area of practice were collected. Results. 273 physiotherapists completed the survey. Overall confidence in managing people with RA was low (22.7–58.2% and need for PD was high (45.1–95.2%. Physiotherapists with greater years of clinical experience, a caseload of consumers with RA, postgraduate qualifications in musculoskeletal physiotherapy, or who worked in the musculoskeletal area were more confident in managing people with RA and less likely to need PD. Online and face-to-face formats were preferred modes of PD delivery. Discussion. To enable community-based RA service delivery to be effectively established, subgroups within the current physiotherapy workforce require upskilling in the evidence-based management of consumers with RA.

  4. Are patients willing participants in the new wave of community-based medical education in regional and rural Australia?

    Science.gov (United States)

    Hudson, J Nicky; Weston, Kathryn M; Farmer, Elizabeth E; Ivers, Rowena G; Pearson, Russell W

    2010-02-01

    Community-based medical education is growing to meet the increased demand for quality clinical education in expanded settings, and its sustainability relies on patient participation. This study investigated patients' views on being used as an educational resource for teaching medical students. Questionnaire-based survey. Patients attending six rural and 11 regional general practices in New South Wales over 18 teaching sessions in November 2008, who consented to student involvement in their consultation. Patient perceptions, expectations and acceptance of medical student involvement in consultations, assessed by surveys before and after their consultations. 118 of 122 patients consented to medical student involvement; of these, 117 (99%) completed a survey before the consultation, and 100 (85%) after the consultation. Patients were overwhelmingly positive about their doctor and practice being involved in student teaching and felt they themselves played an important role. Pre-consultation, patients expressed reluctance to allow students to conduct some or all aspects of the consultation independently. However, after the consultation, they reported they would have accepted higher levels of involvement than actually occurred. Patients in regional and rural settings were willing partners in developing skills of junior medical students, who had greater involvement in patient consultations than previously reported for urban students. Our study extends the findings from urban general practice that patients are underutilised partners in community-based medical training. The support of patients from regional and rural settings could facilitate the expansion of primary care-based medical education in these areas of workforce need.

  5. The feasibility of using a peer-guided model to enhance participation in community-based physical activity for youth with intellectual disability.

    Science.gov (United States)

    Temple, Viviene A; Stanish, Heidi I

    2011-09-01

    We examined the feasibility of a using a peer-guided model to foster participation of youth with intellectual disability in community-based exercise. The intervention was designed to address personal barriers to exercise commonly faced by individuals with intellectual disability. Twenty adolescents with mild-moderate intellectual disability and 14 typically developing peers exercised in groups of two or three, 2 days per week for 15 weeks at YMCAs. Each dyad or triad provided reciprocal support during structured, individualized exercise sessions led by certified fitness trainers. Adherence to the program was high and youth with intellectual disability showed a significant reduction in personal barriers. They also felt they had learned new skills and made new friends. Typically developing youth were also positive about their experience as a volunteer. Our findings suggest that a peer-guided exercise model is useful for enhancing participation in community-based exercise.

  6. Perception of orthodox health care centers among pregnant women attending traditional birth attendants clinics in two local government areas of Lagos State

    Directory of Open Access Journals (Sweden)

    A Okewole

    2013-01-01

    Full Text Available Background and Objective: Adequate antenatal care and skilled obstetric assistance during delivery are important strategies that significantly reduce maternal mortality and morbidity. This study aimed to assess the awareness, attitudes and perception of orthodox health care centres among pregnant women patronizing traditional birth attendants in Mushin and Lagos Island local government areas of Lagos state. Methods: The survey was a community-based descriptive cross-sectional survey that employed interviews to collect data from 300 antenatal care attendees of seven traditional birth attendants′ clinics in Lagos Island and Mushin local government areas between December 2010 and January 2011 using a structured questionnaire. Results: The women ranged in age from 17-43 years with a mean age of 27.6 ± 4.6 SD and most of them were primigravidas (41.5%, married (88% and traders (44.1%. Most of the women (61% and their husbands (56.7% had completed their secondary education. The majority (81.7% of respondents were aware of a modern health facility around where they lived, the most commonly known being private hospitals (43.7%. Most of them (67.3% were aware of antenatal care services provided at these facilities but only 31.3% had ever made use of the antenatal services. Most of the women were not willing to deliver in hospitals because they didn′t like the attitude of the health workers (37.3% and because it was far from their houses (12.7%; the majority (75% preferring to deliver with traditional birth attendants because they give good service. However, almost all (98.5% of the women that had children took them to the orthodox health facilities for immunization, primarily the primary health care centers (55.7%. Conclusion: Traditional birth attendants are patronized by a wide array of women who are aware of orthodox health facilities but have a negative attitude towards their services. Improvements in communication and interpersonal skills of

  7. The practice of neogeography in community-based organizations

    Science.gov (United States)

    Oberle, Patrick

    Neogeography and Volunteered Geographic Information (VGI) are two terms that have emerged recently to describe the practice of geography by those not formally trained in it as a discipline and spatial data provided by individuals through social media and other Web-based tools. Both neogeography and VGI can be directly linked to the growth of various online mapping websites and applications that allow for the creation of electronic maps that are interactive, adaptable, and easily shared via the Internet and Web. As recent phenomena, the practice of neogeography and VGI is not well understood, nor are the links these new fields have to previously established knowledge on Geographic Information Systems and its associated practices. This thesis attempts to fill this knowledge gap through a participatory study of neogeographic practice. Using a participatory workshop format, I observed and documented representatives of community-based organizations in Syracuse, NY as they encountered online mapping tools for the first time. I followed up with two of those organizations in longer case studies to better understand how organizations with no obvious geographic focus come to see geography as a way of communicating complex ideas about space. This study revealed that while the technical complexity of the online mapping software continues to prove to be a hindrance to its use, there remains space for professional geographers to interact with laypeople who make maps. Furthermore, such engagement is necessary to begin to understand the issues involved with location-based information and privacy, access to data, and ability to use and communicate geographic concepts and knowledge.

  8. A community-based study of asthenopia in computer operators

    Directory of Open Access Journals (Sweden)

    Bhanderi Dinesh

    2008-01-01

    Full Text Available Context: There is growing body of evidence that use of computers can adversely affect the visual health. Considering the rising number of computer users in India, computer-related asthenopia might take an epidemic form. In view of that, this study was undertaken to find out the magnitude of asthenopia in computer operators and its relationship with various personal and workplace factors. Aims: To study the prevalence of asthenopia among computer operators and its association with various epidemiological factors. Settings and Design: Community-based cross-sectional study of 419 subjects who work on computer for varying period of time. Materials and Methods: Four hundred forty computer operators working in different institutes were selected randomly. Twenty-one did not participate in the study, making the nonresponse rate 4.8%. Rest of the subjects (n = 419 were asked to fill a pre-tested questionnaire, after obtaining their verbal consent. Other relevant information was obtained by personal interview and inspection of workstation. Statistical Analysis Used: Simple proportions and Chi-square test. Results: Among the 419 subjects studied, 194 (46.3% suffered from asthenopia during or after work on computer. Marginally higher proportion of asthenopia was noted in females compared to males. Occurrence of asthenopia was significantly associated with age of starting use of computer, presence of refractive error, viewing distance, level of top of the computer screen with respect to eyes, use of antiglare screen and adjustment of contrast and brightness of monitor screen. Conclusions: Prevalence of asthenopia was noted to be quite high among computer operators, particularly in those who started its use at an early age. Individual as well as work-related factors were found to be predictive of asthenopia.

  9. Team sponsors in community-based health leadership programs.

    Science.gov (United States)

    Patterson, Tracy Enright; Dinkin, Donna R; Champion, Heather

    2017-05-02

    Purpose The purpose of this article is to share the lessons learned about the role of team sponsors in action-learning teams as part of community-based health leadership development programs. Design/methodology/approach This case study uses program survey results from fellow participants, action learning coaches and team sponsors to understand the value of sponsors to the teams, the roles they most often filled and the challenges they faced as team sponsors. Findings The extent to which the sponsors were perceived as having contributed to the work of the action learning teams varied greatly from team to team. Most sponsors agreed that they were well informed about their role. The roles sponsors most frequently played were to provide the teams with input and support, serve as a liaison to the community and serve as a sounding board, motivator and cheerleader. The most common challenges or barriers team sponsors faced in this role were keeping engaged in the process, adjusting to the role and feeling disconnected from the program. Practical implications This work provides insights for program developers and community foundations who are interested in building the capacity for health leadership by linking community sponsors with emerging leaders engaged in an action learning experience. Originality/value This work begins to fill a gap in the literature. The role of team sponsors has been studied for single organization work teams but there is a void of understanding about the role of sponsors with multi-organizational teams working to improve health while also learning about leadership.

  10. Community-based Participatory Research Examining the Health Care Needs of African Americans who are Homeless with Mental Illness

    Science.gov (United States)

    Corrigan, Patrick; Pickett, Susan; Kraus, Dana; Burks, Raymond; Schmidt, Anne

    2017-01-01

    African Americans with mental illness who are homeless experience significant health risks and illnesses leading to high mortality and morbidity rates. A community-based participatory research (CBPR) team conducted a qualitative study to begin to describe these problems. Results from focus groups and key informant interviews of 42 individuals yielded 98 themes which were sorted into three categories: problems, solutions, and peer navigators. Results included a review of the problems and solutions which the community or people might adopt. An additional goal was to understand and develop impact of peer navigators for addressing health problems in this group. Results yielded a list of values in hiring peer navigators as well as skills and resources they might need to successfully do their job. Findings from the study are currently being used by the CBPR team to develop a peer navigator program for this community. PMID:25702732

  11. Social work decision-making: need factors of older adults that affect outcomes of home- and community-based services.

    Science.gov (United States)

    Joostepn, Dawn Marie

    2015-02-01

    The purposes of this study were to examine social work decision-making outcomes of home- and community-based services (HCBS) referrals provided to older adults with unmet physical and psychosocial needs discharged from acute care to a community setting, and to understand older adults' (N=247) responses to receiving referrals for HCBS. Older adults with inadequately or marginally met basic needs was a statistically significant predictor of the number of HCBS referrals home health social workers provided to older adult clients (p social work home visit. Implications for practice were suggested for clinical social workers.and case managers providing HCBS referrals to older adults with unmet physical and psychosocial needs discharged from acute care or skilled care to community settings.

  12. Interpersonal Skills

    Directory of Open Access Journals (Sweden)

    Barakat NG

    2007-01-01

    Full Text Available INTRODUCTIONInterpersonal skills are becoming more and more a necessity in the medical profession. The expectation from health care professionals is beyond just knowledge of the medical facts. To practice medicine effectively, doctors need to develop interpersonal skills in communication, leadership, management, teaching and time management. All of these are vital tools and are becoming increasingly essential subjects in teaching both undergraduate students and postgraduate doctors. However, a degree of self-motivation and personal initiative is needed to develop these skills. In this article, I will give an overview on interpersonal skills and will be follow this by a series of articles, in future issues, dealing with these skills.

  13. Delivery of Community-Based Care Through Inter-professional Teams in Brazil's Unified Health System (UHS): Comparing Perceptions Across Community Health Agents (CHAs), Nurses and Physicians.

    Science.gov (United States)

    Rahman, Rahbel; Pinto, Rogério Meireles; Zanchetta, Margareth Santos; Wall, Melanie M

    2017-05-27

    Given the shortage of medical providers and the need for medical decisions to be responsive to community needs, including lay health providers in health teams has been recommended as essential for the successful management of global health care systems. Brazil's Unified Health System (UHS) is a model for delivering community-based care through Family Health Strategy (FHS) interdisciplinary teams comprised of medical and lay health providers-Community Health Agents (CHAs), nurses, and physicians. This study aims to understand how medical and lay health providers' perceptions and attitudes could impact the delivery of community-based care. The study compares perceptions and attitudes of 168 CHAs, 62 nurses, and 32 physicians across their job context, professional capacities, professional skills, and work environment. Descriptive and bivariate analysis were performed. CHAs reported being the most efficacious amongst the providers. Physicians reported incorporating consumer-input to a lesser degree than nurses and CHAs. CHAs reported using a lesser variety of skills than physicians. A significant proportion of physicians compared to CHAs and nurses reported that they had decision-making autonomy. Providers did not report differences that lack of resources and poor work conditions interfered with their ability to meet consumer needs. This study offers technocratic perspectives of medical and lay health providers who as an inter-professional team provide community-based primary health care. Implications of the study include proposing training priorities and identifying strategies to integrate lay health providers into medical teams for Brazil's Unified Health System and other health systems that aim to deliver community-based care through inter-professional health teams.

  14. Consulting, Mediating, Conducting, and Supporting: How Community-Based Organizations Engage with Research to Influence Policy

    Science.gov (United States)

    Winton, Sue; Evans, Michael P.

    2016-01-01

    Grounded in critical policy theories and democratic conceptions of research, case studies of three community-based organizations, one in Canada and two in the U.S., were analyzed to determine if and how the groups engaged with research in their efforts to influence education policy. The findings demonstrate that the community-based organizations…

  15. Mechanisms of Power within a Community-Based Food Security Planning Process

    Science.gov (United States)

    McCullum, Christine; Pelletier, David; Barr, Donald; Wilkins, Jennifer; Habicht, Jean-Pierre

    2004-01-01

    A community food security movement has begun to address problems of hunger and food insecurity by utilizing a community-based approach. Although various models have been implemented, little empirical research has assessed how power operates within community-based food security initiatives. The purpose of this research was to determine how power…

  16. Community-Based Field Experiences in Teacher Education: Possibilities for a Pedagogical Third Space

    Science.gov (United States)

    Hallman, Heidi L.

    2012-01-01

    The present article discusses the importance of community-based field experiences as a feature of teacher education programs. Through a qualitative case study, prospective teachers' work with homeless youth in an after-school initiative is presented. Framing community-based field experiences in teacher education through "third space" theory, the…

  17. The Culture of Experiential Community Based Learning: Developing Cultural Awareness in Pre-Service Teachers

    Science.gov (United States)

    Droppert, Alida J.

    2013-01-01

    This paper describes the culture of experiential community based learning at Central College, a rural liberal arts college in Midwestern, USA. Pre-service teachers use experiential community based learning to reflect on their personal growth in understanding the needs of diverse learners. Reflections demonstrate how the program contributes to the…

  18. Cost-Effectiveness of a Community-Based Exercise Programme in COPD Self-Management

    NARCIS (Netherlands)

    Zwerink, Marlies; Effing, Tanja; Kerstjens, Huib A. M.; van der Valk, Paul; Brusse-Keizer, Marjolein; van der Palen, Job

    2016-01-01

    Introduction: Information regarding cost-effectiveness of community-based exercise programmes in COPD is scarce. Therefore, we have investigated whether a community-based exercise programme is a cost-effective component of self-management for patients with COPD after 2 years of follow-up. Methods: A

  19. Unraveling Ethics: Reflections from a Community-Based Participatory Research Project with Youth

    Science.gov (United States)

    Walsh, Christine A.; Hewson, Jennifer; Shier, Michael; Morales, Edwin

    2008-01-01

    There is limited literature describing the ethical dilemmas that arise when conducting community-based participatory research. The following provides a case example of ethical dilemmas that developed during a multi-method community-based participatory action research project with youth in Calgary, Alberta, Canada. Several ethical dilemmas emerged…

  20. Exploring Partnership Functioning within a Community-Based Participatory Intervention to Improve Disaster Resilience

    Science.gov (United States)

    Gagnon, Elizabeth; O'Sullivan, Tracey; Lane, Daniel E.; Paré, Nicole

    2016-01-01

    Disasters happen worldwide, and it is necessary to engage emergency management agencies, health and social services, and community-based organizations in collaborative management activities to enhance community resilience. Community-based participatory research (CBPR) has been widely accepted in public health research as an approach to develop…

  1. Community-Based Research: From Practice to Theory and Back Again.

    Science.gov (United States)

    Stoecker, Randy

    2003-01-01

    Explores the theoretical strands being combined in community-based research--charity service learning, social justice service learning, action research, and participatory research. Shows how different models of community-based research, based in different theories of society and different approaches to community work, may combine or conflict. (EV)

  2. Performing Environmental Change: MED Theatre and the Changing Face of Community-Based Performance Research

    Science.gov (United States)

    Schaefer, Kerrie

    2012-01-01

    This article examines a programme of work produced by community-based theatre company, Manaton and East Dartmoor (MED) Theatre, addressing issues of climate change as they impact on life in rural Devon, UK. After some discussion of MED Theatre's constitution as a community-based company and the group's long-term engagement with the place, history,…

  3. Fostering Sustainable Behavior: An Introduction to Community-Based Social Marketing.

    Science.gov (United States)

    McKenzie-Mohr, Doug; Smith, William

    This book discusses incorporating community-based social marketing techniques programs. The first chapter explains why programs that rely heavily on conventional methods to promote behavior change are often ineffective, and introduces community-based social marketing as an attractive alternative for the delivery of programs. Chapter 2 describes…

  4. Birth control pills overdose

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002599.htm Birth control pill overdose To use the sharing features on ... the medicine was prescribed for the person Poison Control Your local poison center can be reached directly ...

  5. Birth control after 1984.

    Science.gov (United States)

    Djerassi, C

    1970-09-04

    1) Eric Blair (alias George Orwell) can rest easy in his grave, because birth control by governmentally imposed methods, such as incorporation of a contraceptive agent into drinking water, is totally unfeasible by 1984. 2) Fundamentally new birth control procedures in the female (for example, a once-a-month luteolytic or abortifacient agent) and a male contraceptive pill probably will not be developed until the 1980's at the earliest, and then only if major steps of the type outlined in this article are instituted in the early 1970's. Development during the next decade of practical new methods of birth control without important incentives for continued active participation by the pharmaceutical industry is highly unlikely. If none are developed, birth control in 1984 will not differ significantly from that of today.

  6. Wealthy Flou Birth Control

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    China’s family planning policies have come under criticism for failing to con birth rates among wealthy families A ccording to the family planning policies, Hong Youfu, a restaurant owner in Fangcun District of

  7. Accredited Birth Centers

    Science.gov (United States)

    ... 9743 Accredited since January 2016 98 Bright Eyes Midwifery and Wild Rivers Women's Health Accredited 29135 Ellensburg ... Accredited since November 2015 96 Footprints in Time Midwifery Services and Birth Center Accredited 351 N. Water ...

  8. The development of a lay health worker delivered collaborative community based intervention for people with schizophrenia in India

    Directory of Open Access Journals (Sweden)

    Balaji Madhumitha

    2012-02-01

    Full Text Available Abstract Background Care for schizophrenia in low and middle income countries is predominantly facility based and led by specialists, with limited use of non-pharmacological treatments. Although community based psychosocial interventions are emphasised, there is little evidence about their acceptability and feasibility. Furthermore, the shortage of skilled manpower is a major barrier to improving access to these interventions. Our study aimed to develop a lay health worker delivered community based intervention in three sites in India. This paper describes how the intervention was developed systematically, following the MRC framework for the development of complex interventions. Methods We reviewed the lierature on the burden of schizophrenia and the treatment gap in low and middle income countries and the evidence for community based treatments, and identified intervention components. We then evaluated the acceptability and feasibility of this package of care through formative case studies with individuals with schizophrenia and their primary caregivers and piloted its delivery with 30 families. Results Based on the reviews, our intervention comprised five components (psycho-education; adherence management; rehabilitation; referral to community agencies; and health promotion to be delivered by trained lay health workers supervised by specialists. The intervention underwent a number of changes as a result of formative and pilot work. While all the components were acceptable and most were feasible, experiences of stigma and discrimination were inadequately addressed; some participants feared that delivery of care at home would lead to illness disclosure; some participants and providers did not understand how the intervention related to usual care; some families were unwilling to participate; and there were delivery problems, for example, in meeting the targeted number of sessions. Participants found delivery by health workers acceptable, and

  9. Using community-based participatory research and organizational diagnosis to characterize relationships between community leaders and academic researchers

    Directory of Open Access Journals (Sweden)

    Karen H. Wang

    2017-09-01

    Full Text Available Sustaining collaborations between community-based organization leaders and academic researchers in community-engaged research (CEnR in the service of decreasing health inequities necessitates understanding the collaborations from an inter-organizational perspective. We assessed the perspectives of community leaders and university-based researchers conducting community-engaged research in a medium-sized city with a history of community-university tension. Our research team, included experts in CEnR and organizational theory, used qualitative methods and purposeful, snowball sampling to recruit local participants and performed key informant interviews from July 2011–May 2012. A community-based researcher interviewed 11 community leaders, a university-based researcher interviewed 12 university-based researchers. We interviewed participants until we reached thematic saturation and performed analyses using the constant comparative method. Unifying themes characterizing community leaders and university-based researchers' relationships on the inter-organizational level include: 1 Both groups described that community-engaged university-based researchers are exceptions to typical university culture; 2 Both groups described that the interpersonal skills university-based researchers need for CEnR require a change in organizational culture and training; 3 Both groups described skepticism about the sustainability of a meaningful institutional commitment to community-engaged research 4 Both groups described the historical impact on research relationships of race, power, and privilege, but only community leaders described its persistent role and relevance in research relationships. Challenges to community-academic research partnerships include researcher interpersonal skills and different perceptions of the importance of organizational history. Solutions to improve research partnerships may include transforming university culture and community

  10. Applying community-based participatory research to better understand and improve kinship care practices

    DEFF Research Database (Denmark)

    Chukwudozie, Oge; Feinstein, Clare; Jensen, Celina

    2015-01-01

    While the principles behind community-based participatory research are firmly established, the process of taking community-based participatory research with children and youth to scale and integrating it into the programming of non-governmental organizations has been scarcely documented. This art......While the principles behind community-based participatory research are firmly established, the process of taking community-based participatory research with children and youth to scale and integrating it into the programming of non-governmental organizations has been scarcely documented....... This article reflects on the experiences of Save the Children in implementing a multicountry community-based participatory research program to increase understanding of kinship care in the Democratic Republic of Congo, Nigeria, and Sierra Leone. The article discusses challenges faced and lessons learned...... and highlights how the research process enabled action and advocacy initiatives at different levels-leading to an increase in support and policy attention for children living in kinship care....

  11. Practices of Early Childhood Development Practitioners for Poor and Vulnerable Children from Birth to Four Years in South Africa

    Science.gov (United States)

    Ebrahim, Hasina Banu; Killian, Bev; Rule, Peter

    2011-01-01

    This article explores the practices undertaken by early childhood development practitioners (ECDPs) to support poor and vulnerable children from birth to four years outside centre-based provision. The article draws on part of a UNICEF (United Nations International Children's Fund) commissioned evaluation on family and community-based ECD (Early…

  12. Practices of Early Childhood Development Practitioners for Poor and Vulnerable Children from Birth to Four Years in South Africa

    Science.gov (United States)

    Ebrahim, Hasina Banu; Killian, Bev; Rule, Peter

    2011-01-01

    This article explores the practices undertaken by early childhood development practitioners (ECDPs) to support poor and vulnerable children from birth to four years outside centre-based provision. The article draws on part of a UNICEF (United Nations International Children's Fund) commissioned evaluation on family and community-based ECD (Early…

  13. Prevalence and predictors of giving birth in health facilities in Bugesera District, Rwanda

    Directory of Open Access Journals (Sweden)

    Joharifard Shahrzad

    2012-12-01

    Full Text Available Abstract Background The proportion of births attended by skilled health personnel is one of two indicators used to measure progress towards Millennium Development Goal 5, which aims for a 75% reduction in global maternal mortality ratios by 2015. Rwanda has one of the highest maternal mortality ratios in the world, estimated between 249–584 maternal deaths per 100,000 live births. The objectives of this study were to quantify secular trends in health facility delivery and to identify factors that affect the uptake of intrapartum healthcare services among women living in rural villages in Bugesera District, Eastern Province, Rwanda. Methods Using census data and probability proportional to size cluster sampling methodology, 30 villages were selected for community-based, cross-sectional surveys of women aged 18–50 who had given birth in the previous three years. Complete obstetric histories and detailed demographic data were elicited from respondents using iPad technology. Geospatial coordinates were used to calculate the path distances between each village and its designated health center and district hospital. Bivariate and multivariate logistic regressions were used to identify factors associated with delivery in health facilities. Results Analysis of 3106 lifetime deliveries from 859 respondents shows a sharp increase in the percentage of health facility deliveries in recent years. Delivering a penultimate baby at a health facility (OR = 4.681 [3.204 - 6.839], possessing health insurance (OR = 3.812 [1.795 - 8.097], managing household finances (OR = 1.897 [1.046 - 3.439], attending more antenatal care visits (OR = 1.567 [1.163 - 2.112], delivering more recently (OR = 1.438 [1.120 - 1.847] annually, and living closer to a health center (OR = 0.909 [0.846 - 0.976] per km were independently associated with facility delivery. Conclusions The strongest correlates of facility-based delivery in Bugesera District include previous delivery at a

  14. Especially for Teens: Birth Control

    Science.gov (United States)

    ... against sexually transmitted infections (STIs)? • What is the birth control pill? • What is the skin patch? • What is the ... birth control? • What are the types of emergency birth control pills? • Where can I get emergency birth control? •Glossary ...

  15. Development of a Community-Based Rehabilitation Intervention for People with Schizophrenia in Ethiopia.

    Science.gov (United States)

    Asher, Laura; Fekadu, Abebaw; Hanlon, Charlotte; Mideksa, Gemechu; Eaton, Julian; Patel, Vikram; De Silva, Mary J

    2015-01-01

    Community-based rehabilitation (CBR) is a multi-sectoral strategy to improve the functioning and quality of life of people with disabilities. The RISE (Rehabilitation Intervention for people with Schizophrenia in Ethiopia) trial will evaluate the effectiveness of CBR for people with schizophrenia in Ethiopia. Nevertheless, the components of CBR that are both feasible and likely to prove effective in low and middle-income countries such as Ethiopia are unclear. In this study intervention development work was undertaken to design a CBR intervention that is acceptable and feasible in the local context. The development work consisted of five phases. 1: Identify potential components of CBR for schizophrenia, 2: Situational analysis, 3: Determine feasibility of CBR (Theory of Change workshops with experts and local stakeholders), 4: Determine acceptability of CBR (16 in-depth interviews and five focus group discussions with people with schizophrenia, caregivers, health workers and community leaders) and 5: Synthesise results to finalise intervention. A Theory of Change map was constructed showing the causal pathway for how we expect CBR to achieve its impact. People with schizophrenia in rural Ethiopia experience family conflict, difficulty participating in work and community life, and stigma. Stakeholders perceived CBR to be acceptable and useful to address these problems. The focus of CBR will be on the individual developing the skills and confidence to perform their previous or desired roles and activities. To ensure feasibility, non-health professionals will be trained to deliver CBR and provide supervision, rather than mental health specialists. Novel components of CBR for schizophrenia included family intervention and dealing with distressing symptoms. Microfinance was excluded due to concerns about stress and exploitation. Community mobilisation was viewed as essential to ensure the effectiveness and sustainability of CBR. Extensive formative research using a

  16. Community-Based Coastal Resource Management (CB-CRM: a Case Study f Mariveles, Bataan, Philippines

    Directory of Open Access Journals (Sweden)

    Andrew Lou L. Mungcal

    2013-11-01

    Full Text Available This paper addressed the issue of sustainable coastal resource management through a successful Community-Based Coastal Resource Management (CB-CRM Program in the Municipality of Mariveles, province of Bataan in the Philippines. The paper investigated how governance and institutional and legislative framework, and the concept of sustainable development complemented each other to promote good local eco-governance in the management and protection of finite local marine resources. Specifically, it analyzed how the local fisherfolk community of Mariveles utilized efficiently their finite marine resources in the context of eco-governance. It also investigated how the cooperative efforts of various stakeholders: peoples’ organizations (POs, local government unit (LGU, and a non-government organization (NGO in Mariveles, Bataan affected their coastal resources against environmental degradation and exploitation. This paper would benefit POs, LGUs, and NGOs in their quest for sustainable management and conservation of their limited coastal resources. This paper yielded the following findings. First, POs and NGOs engage when NGOs can strengthen the POs’ capacity building through the transfer of skills and technology, when NGOs can enhance the POs’ indigenous knowledge, and when NGOs are more knowledgeable of formal venues of LGU participation. Second, LGUs, NGOs and POs engage when POs and NGOs can complement each other to strengthen their capacity building, and when NGOs can help implement environmental programs that are beneficial to the POs. Third, NGOs and POs engage when POs are threatened by elite power, and when NGOs want their environmental issues on LGU’s legislative agenda. Finally, NGOs and POs engage when they see possible LGU cooperation. Participant observation through focus group discussion (FGD and key informants’ interview of different stakeholders was a primary source of information in formulating the aforementioned conclusions

  17. Community-based interventions for obesity prevention: lessons learned by Australian policy-makers

    Directory of Open Access Journals (Sweden)

    Haby Michelle M

    2012-01-01

    Full Text Available Abstract Background Interest in community-based interventions (CBIs for health promotion is increasing, with a lot of recent activity in the field. This paper aims, from a state government perspective, to examine the experience of funding and managing six obesity prevention CBIs, to identify lessons learned and to consider the implications for future investment. Specifically, we focus on the planning, government support, evaluation, research and workforce development required. Methods The lessons presented in this paper come from analysis of key project documents, the experience of the authors in managing the projects and from feedback obtained from key program stakeholders. Results CBIs require careful management, including sufficient planning time and clear governance structures. Selection of interventions should be based on evidence and tailored to local needs to ensure adequate penetration in the community. Workforce and community capacity must be assessed and addressed when selecting communities. Supporting the health promotion workforce to become adequately skilled and experienced in evaluation and research is also necessary before implementation. Comprehensive evaluation of future projects is challenging on both technical and affordability grounds. Greater emphasis may be needed on process evaluation complemented by organisation-level measures of impact and monitoring of nutrition and physical activity behaviours. Conclusions CBIs offer potential as one of a mix of approaches to obesity prevention. If successful approaches are to be expanded, care must be taken to incorporate lessons from existing and past projects. To do this, government must show strong leadership and work in partnership with the research community and local practitioners.

  18. Impact of Community-Based Dental Education on Attainment of ADEA Competencies: Students' Self-Ratings.

    Science.gov (United States)

    McFarland, Kimberly K; Nayar, Preethy; Ojha, Diptee; Chandak, Aastha; Gupta, Niodita; Lange, Brian

    2016-06-01

    Fourth-year dental students at the College of Dentistry, University of Nebraska Medical Center participate in a community-based dental education (CBDE) program that includes a four-week rotation in rural dental practices and community health clinics across Nebraska and nearby states. The aim of this study was to assess the impact of participation in the CBDE program on the self-rated competencies of these students. A retrospective survey was administered to students who participated in extramural rotations in two academic years. The survey collected demographic data and asked students to rate themselves on a scale from 1=not competent at all to 5=very competent on attainment of the American Dental Education Association (ADEA) Competencies for the New General Dentist for before and after the rotations. A total of 92 responses were obtained: 43 students for 2011-12 and 49 students for 2012-13 (95% response rate for each cohort). The results showed that the students' mean pre-program self-ratings ranged from 3.28 for the competency domain of Practice Management and Informatics to 3.93 for Professionalism. Their mean post-program self-ratings ranged from 3.76 for Practice Management and Informatics to 4.31 for Professionalism. The students showed a statistically significant increase in self-ratings for all six competency domains. The increase was greatest in the domain of Critical Thinking and least in Communication and Interpersonal Skills. Overall, these results suggest that the CBDE program was effective in improving the students' self-perceptions of competence in all six domains and support the idea that a competency-based evaluation of CBDE programs can provide valuable information to dental educators about program effectiveness.

  19. Making birthing safe for Pakistan women: a cluster randomized trial

    Directory of Open Access Journals (Sweden)

    Khan Muhammad

    2012-07-01

    Full Text Available Abstract Background Two out of three neonatal deaths occur in just 10 countries and Pakistan stands third among them. Maternal mortality is also high with most deaths occurring during labor, birth, and first few hours after birth. Enhanced access and utilization of skilled delivery and emergency obstetric care is the demonstrated strategy in reducing maternal and neonatal mortality. This trial aims to compare reduction in neonate mortality and utilization of available safe birthing and Emergency Obstetric and Neonatal Care services among pregnant mothers receiving ‘structured birth planning’, and/or ‘transport facilitation’ compared to routine care. Methods A pragmatic cluster randomized trial, with qualitative and economic studies, will be conducted in Jhang, Chiniot and Khanewal districts of Punjab, Pakistan, from February 2011 to May 2013. At least 29,295 pregnancies will be registered in the three arms, seven clusters per arm; 1 structured birth planning and travel facilitation, 2 structured birth planning, and 3 control arm. Trial will be conducted through the Lady Health Worker program. Main outcomes are difference in neonatal mortality and service utilization; maternal mortality being the secondary outcome. Cluster level analysis will be done according to intention-to-treat. Discussion A nationwide network of about 100,000 lady health workers is already involved in antenatal and postnatal care of pregnant women. They also act as “gatekeepers” for the child birthing services. This gate keeping role mainly includes counseling and referral for skill birth attendance and travel arrangements for emergency obstetric care (if required. The review of current arrangements and practices show that the care delivery process needs enhancement to include adequate information provision as well as informed “decision” making and planned “action” by the pregnant women. The proposed three-year research is to develop, through national

  20. Place-power-prognosis: Community-based conservation, partnerships, and ecotourism enterprises in Namibia

    Directory of Open Access Journals (Sweden)

    Arthur Frederick Hoole

    2009-08-01

    Full Text Available Namibia’s community-based natural resource management program (CBRNM and communal conservancies have gained international acclaim for rural poverty alleviation and wildlife conservation on the commons. Community-based ecotourism enterprise development has played a central role in the generation of community revenues, employment and additional benefits. The place of community-based ecotourism enterprises in the evolution of Namibia’s conservancies is examined. A participatory rural appraisal (PRA approach was conducted in Namibia as part of recent doctoral research in 2006 and 2007, featuring participant observation, semi-structured key informant interviews and structured communal villager interviews. Findings demonstrate some tangible successes of community-based ecotourism enterprise development, as well as emerging issues in related benefits distribution and power brokering. The case of the Torra Conservancy is profiled as a leading model for success in partnerships between conservancies, as community-based conservation institutions, and tourism enterprises. The experience of Ehi-rovipuka Conservancy is also detailed, to illuminate challenges and prospects for replicating the Torra model. Power relationships between and among private enterprise, community, and the state are elucidated. Ecotourism enterprise development can contribute successfully to community-based conservation. But, issues of power sharing, governance and competition necessitate the further evolution of commons institutions to capture future, sustainable benefits from community-based conservation premised on wildlife and related ecotourism development.

  1. Birth Order and Psychopathology

    Directory of Open Access Journals (Sweden)

    Ajay Risal

    2012-01-01

    Full Text Available Context: Ordinal position the child holds within the sibling ranking of a family is related to intellectual functioning, personality, behavior, and development of psychopathology. Aim: To study the association between birth order and development of psychopathology in patients attending psychiatry services in a teaching hospital. Settings and Design: Hospital-based cross-sectional study. Materials and Methods: Retrospective file review of three groups of patients was carried out. Patient-related variables like age of onset, birth order, family type, and family history of mental illness were compared with psychiatry diagnosis (ICD-10 generated. Statistical Analysis: SPSS 13; descriptive statistics and one-way analysis of variance (ANOVA were used. Results: Mean age of onset of mental illness among the adult general psychiatry patients (group I, n = 527 was found to be 33.01 ± 15.073, while it was 11.68 ± 4.764 among the child cases (group II, n = 47 and 26.74 ± 7.529 among substance abuse cases (group III, n = 110. Among group I patients, commonest diagnosis was depression followed by anxiety and somatoform disorders irrespective of birth order. Dissociative disorders were most prevalent in the first born child (36.7% among group II patients. Among group III patients, alcohol dependence was maximum diagnosis in all birth orders. Conclusions: Depression and alcohol dependence was the commonest diagnosis in adult group irrespective of birth order.

  2. Swimming and birth weight.

    Science.gov (United States)

    Nieuwenhuijsen, Mark J; Northstone, Kate; Golding, Jean

    2002-11-01

    Swimmers can be exposed to high levels of trihalomethanes, byproducts of chlorination disinfection. There are no published studies on the relation between swimming and birth weight. We explored this relation in a large birth cohort, the Avon (England) Longitudinal Study of Parents and Children (ALSPAC), in 1991-1992. Information on the amount of swimming per week during the first 18-20 weeks of pregnancy was available for 11,462 pregnant women. Fifty-nine percent never swam, 31% swam up to 1 hour per week, and 10% swam for longer. We used linear regression to explore the relation between birth weight and the amount of swimming, with adjustment for gestational age, maternal age, parity, maternal education level, ethnicity, housing tenure, drug use, smoking and alcohol consumption. We found little effect of the amount of swimming on birth weight. More highly educated women were more likely to swim compared with less educated women, whereas smokers were less likely to swim compared with nonsmokers. There appears to be no relation between the duration of swimming and birth weight.

  3. Delivering at home or in a health facility? health-seeking behaviour of women and the role of traditional birth attendants in Tanzania.

    Science.gov (United States)

    Pfeiffer, Constanze; Mwaipopo, Rosemarie

    2013-02-28

    Traditional birth attendants retain an important role in reproductive and maternal health in Tanzania. The Tanzanian Government promotes TBAs in order to provide maternal and neonatal health counselling and initiating timely referral, however, their role officially does not include delivery attendance. Yet, experience illustrates that most TBAs still often handle complicated deliveries. Therefore, the objectives of this research were to describe (1) women's health-seeking behaviour and experiences regarding their use of antenatal (ANC) and postnatal care (PNC); (2) their rationale behind the choice of place and delivery; and to learn (3) about the use of traditional practices and resources applied by traditional birth attendants (TBAs) and how they can be linked to the bio-medical health system. Qualitative and quantitative interviews were conducted with over 270 individuals in Masasi District, Mtwara Region and Ilala Municipality, Dar es Salaam, Tanzania. The results from the urban site show that significant achievements have been made in terms of promoting pregnancy- and delivery-related services through skilled health workers. Pregnant women have a high level of awareness and clearly prefer to deliver at a health facility. The scenario is different in the rural site (Masasi District), where an adequately trained health workforce and well-equipped health facilities are not yet a reality, resulting in home deliveries with the assistance of either a TBA or a relative. Instead of focusing on the traditional sector, it is argued that more attention should be paid towards (1) improving access to as well as strengthening the health system to guarantee delivery by skilled health personnel; and (2) bridging the gaps between communities and the formal health sector through community-based counselling and health education, which is provided by well-trained and supervised village health workers who inform villagers about promotive and preventive health services, including

  4. Developing a community-based flood resilience measurement standard

    Science.gov (United States)

    Keating, Adriana; Szoenyi, Michael; Chaplowe, Scott; McQuistan, Colin; Campbell, Karen

    2015-04-01

    Given the increased attention to resilience-strengthening in international humanitarian and development work, there has been concurrent interest in its measurement and the overall accountability of "resilience strengthening" initiatives. The literature is reaching beyond the polemic of defining resilience to its measurement. Similarly, donors are increasingly expecting organizations to go beyond claiming resilience programing to measuring and showing it. However, key questions must be asked, in particular "Resilience of whom and to what?". There is no one-size-fits-all solution. The approach to measuring resilience is dependent on the audience and the purpose of the measurement exercise. Deriving a resilience measurement system needs to be based on the question it seeks to answer and needs to be specific. This session highlights key lessons from the Zurich Flood Resilience Alliance approach to develop a flood resilience measurement standard to measure and assess the impact of community based flood resilience interventions, and to inform decision-making to enhance the effectiveness of these interventions. We draw on experience in methodology development to-date, together with lessons from application in two case study sites in Latin America. Attention will be given to the use of a consistent measurement methodology for community resilience to floods over time and place; challenges to measuring a complex and dynamic phenomenon such as community resilience; methodological implications of measuring community resilience versus impact on and contribution to this goal; and using measurement and tools such as cost-benefit analysis to prioritize and inform strategic decision making for resilience interventions. The measurement tool follows the five categories of the Sustainable Livelihoods Framework and the 4Rs of complex adaptive systems - robustness, rapidity, redundancy and resourcefulness -5C-4R. A recent white paper by the Zurich Flood Resilience Alliance traces the

  5. Engaging and sustaining adolescents in community-based participatory research: structuring a youth-friendly community-based participatory research environment.

    Science.gov (United States)

    LoIacono Merves, Marni; Rodgers, Caryn R R; Silver, Ellen Johnson; Sclafane, Jamie Heather; Bauman, Laurie J

    2015-01-01

    Community-Based Participatory Research partnerships typically do not include adolescents as full community partners. However, partnering with adolescents can enhance the success and sustainability of adolescent health interventions. We partnered with adolescents to address health disparities in a low-income urban community. In partnering with youth, it is important to consider their developmental stage and needs to better engage and sustain their involvement. We also learned the value of a Youth Development framework and intentionally structuring a youth-friendly Community-Based Participatory Research environment. Finally, we will raise some ethical responsibilities to consider when working with youth partners.

  6. Community-based arts initiatives: exploring the science of the arts.

    Science.gov (United States)

    Stein, Catherine H; Faigin, David A

    2015-03-01

    In this introduction to the special issue, we describe some of the rewards and challenges of community-based arts initiatives for our discipline. We explore the inherent tensions between art and science that are reflected in community-based arts activities. We pose larger questions about researching community-based arts activities and defining the arts as a means of promoting social change. The diversity of populations, settings, and issues represented by the papers in the special issue are described and a common set of values, methods of inquiry and action are discussed.

  7. Recommendations for scale-up of community-based misoprostol distribution programs.

    Science.gov (United States)

    Robinson, Nuriya; Kapungu, Chisina; Carnahan, Leslie; Geller, Stacie

    2014-06-01

    Community-based distribution of misoprostol for prevention of postpartum hemorrhage (PPH) in resource-poor settings has been shown to be safe and effective. However, global recommendations for prenatal distribution and monitoring within a community setting are not yet available. In order to successfully translate misoprostol and PPH research into policy and practice, several critical points must be considered. A focus on engaging the community, emphasizing the safe nature of community-based misoprostol distribution, supply chain management, effective distribution, coverage, and monitoring plans are essential elements to community-based misoprostol program introduction, expansion, or scale-up.

  8. Genomics of Preterm Birth

    Science.gov (United States)

    Swaggart, Kayleigh A.; Pavlicev, Mihaela; Muglia, Louis J.

    2015-01-01

    The molecular mechanisms controlling human birth timing at term, or resulting in preterm birth, have been the focus of considerable investigation, but limited insights have been gained over the past 50 years. In part, these processes have remained elusive because of divergence in reproductive strategies and physiology shown by model organisms, making extrapolation to humans uncertain. Here, we summarize the evolution of progesterone signaling and variation in pregnancy maintenance and termination. We use this comparative physiology to support the hypothesis that selective pressure on genomic loci involved in the timing of parturition have shaped human birth timing, and that these loci can be identified with comparative genomic strategies. Previous limitations imposed by divergence of mechanisms provide an important new opportunity to elucidate fundamental pathways of parturition control through increasing availability of sequenced genomes and associated reproductive physiology characteristics across diverse organisms. PMID:25646385

  9. Prevention of preterm birth.

    LENUS (Irish Health Repository)

    Flood, Karen

    2012-02-01

    Preterm birth (delivery before 37 completed weeks of gestation) is common and rates are increasing. In the past, medical efforts focused on ameliorating the consequences of prematurity rather than preventing its occurrence. This approach resulted in improved neonatal outcomes, but it remains costly in terms of both the suffering of infants and their families and the economic burden on society. Increased understanding of the pathophysiology of preterm labor has altered the approach to this problem, with increased focus on preventive strategies. Primary prevention is a limited strategy which involves public education, smoking cessation, improved nutritional status and avoidance of late preterm births. Secondary prevention focuses on recurrent preterm birth which is the most recognisable risk factor. Widely accepted strategies include cervical cerclage, progesterone and dedicated clinics. However, more research is needed to explore the role of antibiotics and anti-inflammatory treatments in the prevention of this complex problem.

  10. Smoking and Preterm Birth.

    Science.gov (United States)

    Ion, Rachel; Bernal, Andrés López

    2015-08-01

    Premature birth is a significant global problem and the leading cause of newborn deaths. Tobacco smoking has been associated with premature birth for over 50 years. The mechanisms through which smoking exerts its effects on pregnancy outcomes remain unclear. In this review, we discuss rates of prematurity and smoking in pregnancy, the evidence of a causal relationship between tobacco and preterm birth, and proposed biochemical pathways through which the interaction is mediated. The suggested mechanisms include nicotine-induced vasoconstriction, carbon monoxide-induced fetal hypoxia, cadmium disruption of calcium signaling, altered steroid hormone production, disruption of prostaglandin synthesis, and changed responses to oxytocin. The relative importance of each of these pathways is yet to be ascertained. Further research is necessary to explore the mechanisms through which smoking exerts its effect on gestational length and the process of parturition. Moreover, the risks of nicotine replacement in pregnancy should be investigated further. © The Author(s) 2014.

  11. Unsanctioned births in China.

    Science.gov (United States)

    Li, L; Ballweg, J A

    1995-05-01

    This study hypothesizes that "unsanctioned" births (beyond the limit authorized by the government) in China are more likely among couples who have strong traditional fertility norms and less likely among couples who adopt new family planning norms. The theoretical framework is based on cultural conflict theory as developed by Sellin. Data are obtained from 6654 ever married women aged under 49 years from the 1987 In-Depth Fertility Survey for Guangdong province. Over 30% of the sample were married before 20 years of age. 20% had 1 child, 26.7% had 2 children, about 23% had 3 children, 13.9% had 4 children, and under 10% had 5 or more children. The average number of living children was 2.5. Findings reveal that socioeconomic status was significantly related to unsanctioned births; they were more common in less developed areas and among women of lower socioeconomic status (SES). Persons living in areas with a high monetary contribution per person in family planning efforts at the county level were less likely to have unsanctioned births. Women who lived in urban areas, worked in state enterprises, and had parents with high educational status were less likely to have unsanctioned births. They were more likely among women who married at an early age, lived with parents after the marriage, had female living children, and had failed pregnancies. They were also more likely among women who had arranged marriages, a traditional desire for large family sizes, an early marriage ideal, and a preference for sons. Knowledge of family planning and greater use of abortion were related to a lower incidence of unsanctioned births. Women who talked with their husbands about their family size desires were less likely to have unsanctioned births. Parental educational attainment only had an influence among rural women. Variables impacted on fertility differently in urban and rural areas.

  12. Cerebral oxygenation after birth

    DEFF Research Database (Denmark)

    Hessel, Trine W; Hyttel-Sorensen, Simon; Greisen, Gorm

    2014-01-01

    AIM: To compare absolute values of regional cerebral tissue oxygenation (cStO2 ) during haemodynamic transition after birth and repeatability during steady state for two commercial near-infrared spectroscopy (NIRS) devices. METHODS: In a prospective observational study, the INVOS 5100C and FORE......: The INVOS and FORE-SIGHT cStO2 estimates showed oxygenation-level-dependent difference during birth transition. The better repeatability of FORE-SIGHT could be due to the lower response to change in saturation....

  13. Birth room images

    DEFF Research Database (Denmark)

    Bowden, Calida; Sheehan, Athena; Foureur, Maralyn Jean

    2016-01-01

    Objective: this study examined images of birth rooms in developed countries to analyse the messages and visual discourse being communicated through images. Design: a small qualitative study using Kress and van Leeuwen's (2006) social semiotic theoretical framework for image analysis, a form...... of discourse analysis. Setting/participants: forty images of birth rooms were collected in 2013 from Google Images, Flickr, Wikimedia Commons and midwifery colleagues. The images were from obstetric units, alongside and freestanding midwifery units located in developed countries (Australia, Canada, Europe, New...

  14. Music training improves speech-in-noise perception: Longitudinal evidence from a community-based music program.

    Science.gov (United States)

    Slater, Jessica; Skoe, Erika; Strait, Dana L; O'Connell, Samantha; Thompson, Elaine; Kraus, Nina

    2015-09-15

    Music training may strengthen auditory skills that help children not only in musical performance but in everyday communication. Comparisons of musicians and non-musicians across the lifespan have provided some evidence for a "musician advantage" in understanding speech in noise, although reports have been mixed. Controlled longitudinal studies are essential to disentangle effects of training from pre-existing differences, and to determine how much music training is necessary to confer benefits. We followed a cohort of elementary school children for 2 years, assessing their ability to perceive speech in noise before and after musical training. After the initial assessment, participants were randomly assigned to one of two groups: one group began music training right away and completed 2 years of training, while the second group waited a year and then received 1 year of music training. Outcomes provide the first longitudinal evidence that speech-in-noise perception improves after 2 years of group music training. The children were enrolled in an established and successful community-based music program and followed the standard curriculum, therefore these findings provide an important link between laboratory-based research and real-world assessment of the impact of music training on everyday communication skills. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Genetic Evidence for Causal Relationships Between Maternal Obesity-Related Traits and Birth Weight

    DEFF Research Database (Denmark)

    Tyrrell, Jessica; Richmond, Rebecca C; Palmer, Tom M

    2016-01-01

    IMPORTANCE: Neonates born to overweight or obese women are larger and at higher risk of birth complications. Many maternal obesity-related traits are observationally associated with birth weight, but the causal nature of these associations is uncertain. OBJECTIVE: To test for genetic evidence...... of causal associations of maternal body mass index (BMI) and related traits with birth weight. DESIGN, SETTING, AND PARTICIPANTS: Mendelian randomization to test whether maternal BMI and obesity-related traits are potentially causally related to offspring birth weight. Data from 30,487 women in 18 studies...... were analyzed. Participants were of European ancestry from population- or community-based studies in Europe, North America, or Australia and were part of the Early Growth Genetics Consortium. Live, term, singleton offspring born between 1929 and 2013 were included. EXPOSURES: Genetic scores for BMI...

  16. Factors associated with preterm, early preterm and late preterm birth in Malawi.

    Directory of Open Access Journals (Sweden)

    Nynke R van den Broek

    Full Text Available BACKGROUND: Assessment of risk factors for preterm birth in a population with high incidence of preterm birth and HIV infection. METHODS: Secondary analysis of data for 2,149 women included in a community based randomized placebo controlled trial for the prevention of preterm birth (APPLe trial (ISRCTN84023116 with gestational age at birth determined through ultrasound measurement in early pregnancy. Multivariate Logistic Regression analyses to obtain models for three outcome variables: all preterm, early preterm, and late preterm birth. FINDINGS: No statistical differences were noted for the prevalence of HIV infection (p = 0.30 or syphilis (p = 0.12 between women who delivered preterm versus term. BMI (Adjusted OR 0.91 (0.85-0.97; p = 0.005 and weight gain (Adjusted OR 0.89 (0.82-0.97; p = 0.006 had an independent, protective effect. Previous preterm birth doubled the odds of preterm birth (Adjusted OR 2.13 (1.198-3.80; p = 0.01. Persistent malaria (despite malaria prophylaxis increased the risk of late preterm birth (Adjusted OR 1.99 (1.05-3.79; p = 0.04. Age <20 (Adjusted OR 1.73 (1.03-2.90; p = 0.04 and anemia (Adjusted OR 1.95 (1.08-3.52; p = 0.03 were associated with early preterm birth (<34 weeks. CONCLUSIONS: Despite claims that HIV infection is an important cause of preterm birth in Africa, we found no evidence of an association in this population (unexposed to anti-retroviral treatment. Persistent malaria was associated with late preterm birth. Maternal undernourishment and anemia were independently associated with early preterm birth. The study did not assess whether the link was direct or whether a common precursor such as chronic infection was responsible for both maternal effects and early labour.

  17. Exploring Student Engagement and Collaborative Learning in a Community-Based Module in Fine Art

    National Research Council Canada - National Science Library

    John McGarrigle

    2013-01-01

    This article is based on masters research1 into student and civic engagement using a case study of an innovative Community Based Module in a Fine Art degree course (McGarrigle, 2009). 2 (Flyvbjerg, 2006...

  18. Departments of corrections as purchasers of community-based treatment: a national study.

    Science.gov (United States)

    Kubiak, Sheryl Pimlott; Arfken, Cynthia L; Gibson, Erica Shifflet

    2009-06-01

    Community-based substance abuse treatment for offenders has been shown to reduce both substance use and recidivism. One strategy to ensure treatment availability for offenders is to have each state's Department of Corrections (DOC) fund treatment directly. Purchasing treatment implies regulation, but DOC as both a purchaser and regulator of community-based services has been underexamined. This national survey of administrators from the Single State Authority (SSA) and DOC in each state found DOCs purchase treatment in 35 states, with most states purchasing it directly from community-based providers utilizing a variety of funding sources. Fewer states reported DOCs purchased ancillary services than SSAs (68% vs. 81%). Although both DOCs and SSAs had workforce and program requirements, there were differences within and between states. Most (41/42) SSA administrators reported a strong relationship with DOC. This report represents the first step in describing the availability, mechanisms, and regulations of these two publicly funded community-based treatment systems.

  19. 45 CFR 2517.300 - Who may participate in a community-based service-learning program?

    Science.gov (United States)

    2010-10-01

    ... (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE COMMUNITY-BASED SERVICE-LEARNING PROGRAMS Eligibility To Participate § 2517.300 Who may participate in a community-based service-learning program... 45 Public Welfare 4 2010-10-01 2010-10-01 false Who may participate in a community-based service...

  20. 45 CFR 2517.600 - How are funds for community-based service-learning programs distributed?

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false How are funds for community-based service-learning... (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE COMMUNITY-BASED SERVICE-LEARNING PROGRAMS Distribution of Funds § 2517.600 How are funds for community-based service-learning programs distributed? All...

  1. The Birth Order Puzzle.

    Science.gov (United States)

    Zajonc, R. B.; And Others

    1979-01-01

    Discusses the controversy of the relationship between birth order and intellectual performance through a detailed evaluation of the confluence model which assumes that the rate of intellectual growth is a function of the intellectual environment within the family and associated with the special circumstances of last children. (CM)

  2. The Birth of "Frankenstein"

    Science.gov (United States)

    Howard, Jennifer

    2008-01-01

    Nobody shouts "It's alive!" in the novel that gave birth to Frankenstein's monster. "Frankenstein, or the Modern Prometheus," does not feature mad scientists messing around with beakers in laboratories, nor does it deliver any bug-eyed assistants named Igor. Hollywood has given people those stock images, but the story of the monster and his maker…

  3. The Birth of "Frankenstein"

    Science.gov (United States)

    Howard, Jennifer

    2008-01-01

    Nobody shouts "It's alive!" in the novel that gave birth to Frankenstein's monster. "Frankenstein, or the Modern Prometheus," does not feature mad scientists messing around with beakers in laboratories, nor does it deliver any bug-eyed assistants named Igor. Hollywood has given people those stock images, but the story of the monster and his maker…

  4. Visual Memory at Birth.

    Science.gov (United States)

    Slater, Alan; And Others

    1982-01-01

    Explored new-born babys' capacity for forming visual memories. Used an habituation procedure that accommodated individual differences by allowing each infant to control the time course of habituation trials. Found significant novelty preference, providing strong evidence that recognition memory can be reliably demonstrated from birth. (Author/JAC)

  5. Neurobehavioral Assessment before Birth

    Science.gov (United States)

    DiPietro, Janet A.

    2005-01-01

    The complexities of neurobehavioral assessment of the fetus, which can be neither directly viewed nor manipulated, cannot be understated. Impetus to develop methods for measuring fetal neurobehavioral development has been provided by the recognition that individual differences in neurobehavioral functioning do not originate with birth and…

  6. Introducing Midwifery-led Birth Centres to Ontario

    Directory of Open Access Journals (Sweden)

    Cristina A. Mattison

    2015-03-01

    Full Text Available In Ontario, maternal health systems are changing, with an increasing variety of childbirth options being offered to low-risk pregnant women. Midwifery became a regulated profession in the province in 1994: providing primary care throughout pregnancy, labour and for up to six weeks postpartum. Currently there are three midwifery-led birth centres operating in Ontario, two of which opened in early 2014. The Ministry of Health and Long-Term Care (MoHLTC has launched these new birth centres in order to offer women more choice in health care provider and birth setting. This shift is representative of the MoHLTC’s push to move services out of hospitals and into community-based settings. While the birth centre initiative is in its early stages and a formal program evaluation is needed, it has the potential, if scaled up, to decrease the need for hospital beds as well as reduce health care costs through more appropriate care for low-risk pregnancies, leading to fewer interventions.

  7. Introducing Midwifery-led Birth Centres to Ontario

    Directory of Open Access Journals (Sweden)

    Cristina A. Mattison

    2015-03-01

    Full Text Available In Ontario, maternal health systems are changing, with an increasing variety of childbirth options being offered to low-risk pregnant women. Midwifery became a regulated profession in the province in 1994: providing primary care throughout pregnancy, labour and for up to six weeks postpartum. Currently there are three midwifery-led birth centres operating in Ontario, two of which opened in early 2014. The Ministry of Health and Long-Term Care (MoHLTC has launched these new birth centres in order to offer women more choice in health care provider and birth setting. This shift is representative of the MoHLTC’s push to move services out of hospitals and into community-based settings. While the birth centre initiative is in its early stages and a formal program evaluation is needed, it has the potential, if scaled up, to decrease the need for hospital beds as well as reduce health care costs through more appropriate care for low-risk pregnancies, leading to fewer interventions.

  8. Is my drinking a problem? A community-based alcohol intervention programme post-Haiyan in Tacloban City

    Directory of Open Access Journals (Sweden)

    Adam Edward Czaicki

    2015-11-01

    Full Text Available Problem: Evidence on alcohol use following disasters is scarce. After Typhoon Haiyan in the Philippines we wanted to determine whether there were alcohol-related problems among the disaster survivors and to strengthen the appropriate local health service support in Tacloban City. Context: Tacloban City is a highly urbanized city that was one of the areas worst hit by Typhoon Haiyan. Prior to Haiyan there was very little support for people with alcohol problems, and the rehabilitation facility was located about 40 km away. Action: A pilot community-based alcohol intervention programme was conducted that included: assessment of the extent of alcohol problems in the community and health-care workers baseline knowledge and skills; training of health-care workers on primary care alcohol intervention provision; and community outreach with post-training supervision. Outcome: The alcohol screening found 26 (22% of those attending healthcare facilities would benefit from some form of alcohol intervention. Health-care workers knowledge on basic alcohol intervention was low. This was strengthened during the training, and at outreach clinics the trained health-care workers were able to identify people with alcohol problems and provide them with treatment plans. Lessons learnt: We learnt that there was a problem with alcohol in Tacloban City and that it was possible to run an alcohol intervention programme in the community using minimal resources. Addressing alcohol-related issues in the community is an important public health intervention. While there is a need for policies and guidelines at the national level, a community-based intervention is possible to establish with referral mechanism to specialized care. Training modules for such programs can be further developed and institutionalized.

  9. Assessing the quality of service of village malaria workers to strengthen community-based malaria control in Cambodia

    Directory of Open Access Journals (Sweden)

    Ly Po

    2010-04-01

    Full Text Available Abstract Background Malaria continues to be a major public health problem in remote forested areas in Cambodia. As a national strategy to strengthen community-based malaria control, the Cambodian government has been running the Village Malaria Worker (VMW project since 2001. This study sought to examine the nature and quality of the VMWs' services. Methods Data collection was carried out in February and March 2008 through interviews with one of the two VMWs who takes the lead in malaria control activities in each of the 315 VMW villages (n = 251. The questionnaire addressed 1 the sociodemographic characteristics of VMWs, 2 service quality, 3 actions for malaria prevention and vector control, and 4 knowledge of malaria epidemiology and vector ecology. Results VMWs were effective in conducting diagnosis with Rapid Diagnostic Tests (RDTs and prescribing anti-malarials to those who had positive RDT results, skills that they had acquired through their training programmes. However, most other services, such as active detection, explanations about compliance, and follow-up of patients, were carried out by only a small proportion of VMWs. The variety of actions that VMWs took for malaria prevention and vector control was small (average action index score 12.8/23, and their knowledge was very limited with less than 20% of the VMWs giving correct answers to six out of seven questions on malaria epidemiology and vector ecology. Knowledge of vector breeding places and malaria transmission were significant determinants of both the quality of VMWs' services and the variety of their actions for malaria prevention and vector control. Conclusions VMWs' services focused primarily on diagnosis and treatment. Their focus needs to be broadened to cover other aspects of malaria control in order to further strengthen community-based malaria control. VMWs' actions and knowledge also need substantial improvement. Strengthening training programmes can help achieve better

  10. Opportunities, ethical challenges, and lessons learned from working with peer research assistants in a multi-method HIV community-based research study in Ontario, Canada.

    Science.gov (United States)

    Logie, Carmen; James, Llana; Tharao, Wangari; Loutfy, Mona R

    2012-10-01

    We discuss ethical challenges and opportunities experienced by peer research assistants (PRAs) in a multi-method HIV community-based research study in Ontario, Canada. We review lessons learned and best practices based on our experience conducting a qualitative investigation of research priorities with diverse women living with HIV (WLWH) and implementation of a cross-sectional survey with African, Caribbean, and Black WLWH. While some opportunities were similar across research phases for PRAs (e.g., skill building), distinct challenges emerged in qualitative and quantitative phases. For example, our training did not adequately prepare PRAs with focus group facilitation skills; at times, survey implementation became counseling sessions. Researchers should assess how best to support PRAs as part of multi-method research processes.

  11. Birth control and family planning

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/001946.htm Birth control and family planning To use the sharing features ... please enable JavaScript. Your choice of a birth control method depends on a number of factors, including ...

  12. Birth control - slow release methods

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007555.htm Birth control - slow release methods To use the sharing features on this page, please enable JavaScript. Certain birth control methods contain man-made forms of hormones. These ...

  13. Births: preliminary data for 2012.

    Science.gov (United States)

    Hamilton, Brady E; Martin, Joyce A; Ventura, Stephanie J

    2013-09-01

    Objectives-This report presents preliminary data for 2012 on births in the United States. U.S. data on births are shown by age, live-birth order, race, and Hispanic origin of mother. Data on marital status, cesarean delivery, preterm births, and low birthweight are also presented. Methods-Data in this report are based on 99.96% of 2012 births.Records for the few states with less than 100% of records received are weighted to independent control counts of all births received in state vital statistics offices in 2012. Comparisons are made with final 2011 data. Results-The preliminary number of births for the United States in 2012 was 3,952,937, essentially unchanged (not statistically significant) from 2011; the general fertility rate was 63.0 births per 1,000 women aged 15-44, down only slightly from 2011, after declining nearly 3% a year from 2007 through 2010. The number of births and fertility rate either declined or were unchanged for most race and Hispanic origin groups from 2011 to 2012; however, both the number of births and the fertility rate for Asian or Pacific Islander women rose in 2012 (7% and 4%, respectively). The birth rate for teenagers aged 15-19 was down 6% in 2012 (29.4 births per 1,000 teenagers aged 15-19), yet another historic low for the United States, with rates declining for younger and older teenagers and for nearly all race and Hispanic origin groups. The birth rate for women in their early 20s also declined in 2012, to a new record low of 83.1 births per 1,000 women. Birth rates for women in their 30s rose in 2012, as did the birth rate for women in their early 40s. The birth rate for women in their late 40s was unchanged. The nonmarital birth rate declined in 2012 (to 45.3 birth per 1,000 unmarried women aged 15-44), whereas the number of births to unmarried women rose 1% and the percentage of births to unmarried women was unchanged (at 40.7%). The cesarean delivery rate for the United States was unchanged in 2012 at 32.8%. The preterm

  14. The piglet's behavior after birth according to the birth weight

    OpenAIRE

    2008-01-01

    The aim of the work was the piglet's behavior observation till the fourteenth day after birth. We expected some differences in behavior between animal groups according to their birth weight. Thirty-five animals from five litters were included in the experiment. We divided the animals into two groups according to their birth weight: in the first group there were piglets with their birth weight over 1.45 kg; in the second group piglets with their birth weight to 1.35 kg were observ...

  15. Birth Defects Research and Tracking

    Science.gov (United States)

    ... used data from the National Birth Defects Prevention Study (NBDPS) to examine maternal asthma medication use during pregnancy and the risk of certain birth defects. (Published October 22, 2014) World Down Syndrome Day Read one mother’s reflection on the birth ...

  16. Screening for spontaneous preterm birth

    NARCIS (Netherlands)

    van Os, M.A.; van Dam, A.J.E.M.

    2015-01-01

    Preterm birth is the most important cause of perinatal morbidity and mortality worldwide. In this thesis studies on spontaneous preterm birth are presented. The main objective was to investigate the predictive capacity of mid-trimester cervical length measurement for spontaneous preterm birth in a l

  17. Birth of a Second Child

    Science.gov (United States)

    ... Habits for TV, Video Games, and the Internet Birth of a Second Child KidsHealth > For Parents > Birth of a Second Child Print A A A ... pregnant takes a lot of energy. After the birth, expect the first 6 to 8 weeks to ...

  18. Screening for spontaneous preterm birth

    NARCIS (Netherlands)

    van Os, M.A.; van Dam, A.J.E.M.

    2015-01-01

    Preterm birth is the most important cause of perinatal morbidity and mortality worldwide. In this thesis studies on spontaneous preterm birth are presented. The main objective was to investigate the predictive capacity of mid-trimester cervical length measurement for spontaneous preterm birth in a

  19. Profile and birthing practices of Maranao traditional birth attendants

    Directory of Open Access Journals (Sweden)

    Maghuyop-Butalid R

    2015-10-01

    Full Text Available Roselyn Maghuyop-Butalid, Norhanifa A Mayo, Hania T Polangi College of Nursing, Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines Abstract: This study determined the profile and birthing practices in both modern and traditional ways among Maranao traditional birth attendants (TBAs in Lanao del Norte, Philippines. It employed a descriptive research design. The respondents were 50 Maranao TBAs selected through the snowball sampling technique. A questionnaire was developed by the researchers to identify the respondents’ modern birthing practices utilizing the Essential Intrapartum and Newborn Care (EINC Protocol. To determine their profile and traditional birthing practices, items from a previous study and the respondents’ personal claims were adapted. This study shows that Maranao TBAs have less compliance to the EINC Protocol and they often practice the traditional birthing interventions, thus increasing the risk of complications to both mother and newborn. Keywords: intrapartum and newborn care, modern birthing practices, traditional birthing practices 

  20. Female work experience, employment status, and birth expectations: sequential decision-making in the Philippines.

    Science.gov (United States)

    Rosenzweig, M R

    1976-08-01

    The influence of women's birth parity and accumulated market skills on their current labor force participation and birth expectations is examined within a sequential choice framework. Analysis of household data from the 1973 Philippines National Demographic Survey suggests these patterns: (a) women who have accumulated larger families work less in the current period and anticipate fewer additional births; (b) women with more past work experience tend to work more hours in the current period; and (c) work experience appears to have only a weak negative effect on birth expectations among older women.

  1. Planned place of birth

    DEFF Research Database (Denmark)

    Overgaard, Charlotte; Coxon, Kirstie; Stewart, Mary

    of recent research on this topic. Individual papers/studies Stewart, M et al: The Birthplace in England Study – maternal outcomes and issues of choice and equity Overgaard, C et al: Freestanding midwifery units versus obstetric units – outcomes, care perceptions, equity and access in maternity care...... in Denmark Coxon K et al: Planned place of birth in England: perceptions of accessing obstetric units, midwife led units and home birth amongst women and their partners. How these papers interrelate These papers draw upon recent research in maternity care, undertaken in Denmark and in England. In both...... countries, maternity care is provided free to women, through public financing of health care; universal access to care is therefore secured. Nevertheless, different models of care exist, and debates about the appropriateness of providing maternity care in different settings take place in both countries...

  2. Modeling community-based, self-help mental health rehabilitation reform.

    Science.gov (United States)

    Lloyd, Robbie

    2007-01-01

    The research used supported collaborative inquiry in participative action research to record the effectiveness of peer support and narrative therapy, in an indigenous-informed community of belonging, or open urban tribe. There were three objectives: (i) to identify the active attributes of consciousness among those living with intellectual disability and/or mental illness, which can be acknowledged, nurtured and developed to strengthen their balanced self-awareness, and assist them in taking more responsibility for their lives; (ii) to identify how these aspects of self awareness can be used to inform improved individual and group empowerment and improved rehabilitation practice, in communities of inter-subjective relationship and belonging, and; (iii) by exploring collaborative engagement with 'the system' which serves these two groups, to identify how they can more effectively be empowered to manage the planning, policies, programs and service delivery which largely determine their quality of life. The research also seeks to clarify how this person-valuing approach can be applied, in a self-help, peer-supported, community-based rehabilitation system. People living with mental illness and/or intellectual disability experience improved quality of life and self-determining sense of self when they are included in mixed open urban tribes, or communities of belonging. The predominant way this comes about is through the diverse shared metaphors of being which the participants provide for each other, through their energy of life and testimonies of experience which give each other encouragement and stimulation, generating motivation and strengthened intention for life. It is not the cognitive or social ability to perform particular skills in individual or group exchange that determines the impact of this open urban tribal model; it is more the spirit and essence of the people, and their way of exchanging loving interaction and generous caring, listening and feedback that

  3. Development of community based curriculum on ophthalmology for under graduate medical course in Bangladesh.

    Science.gov (United States)

    Khan, A K; Hussain, A Z M I

    2012-08-01

    The curriculum represents the expression of educational ideas in practice. Ophthalmic education is the corner stone to improve eye care globally. Curriculum needs continuous modification varying in different geographic locations. Though 90% of common conditions are either preventable or curable but emphasis on the common conditions is inadequate. This is a stepwise descriptive study aiming to develop a community based ophthalmology curriculum for undergraduate medical course in Bangladesh conducted during March 2007 to February 2008 at UniSA School of Public Health and Life Sciences, University of South Asia, Banani, Dhaka. Delphi technique, a modified qualitative method was used to accumulate data and reaching a consensus opinion for developing the curriculum. Study approach includes two iterative rounds and finally a workshop. Iteration of round-I was "What are the eye diseases with overall knowledge of their management one MBBS physician should acquire"; followed by a list of eye diseases and topics for expert opinion. The response was collated. Iteration round-II was "How much a MBBS student should have percentage of knowledge, attitude and skills on each topic while being taught". The response was collated and presented to panel of expert ophthalmologists for discussion and validation. In the round-I Delphi, 400 (62%) out to total 641 ophthalmologist were randomly selected dividing in categories (62% in each) of Professor-22, Associate Professor-12, Assistant Professor-26, Consultant-27, ophthalmologists working in NGO-56 and ophthalmologists in private sector-257. Sixty (15%) responded with opinion. In the round-II, 200 (31%) including 60 of round-I, selected randomly but proportionately as before. Forty five (22.5%) responded with opinion. Result collated. The results and opinion of respondents were presented at a workshop attended by 24 (80%), out of 30 invited expert ophthalmic specialists for discussion, criticism, opinion, addition, modification and

  4. Community-Based Wetland Restoration Workshop in the Lower Ninth Ward, New Orleans

    Science.gov (United States)

    Wang, H. F.; Craig, L.; Ross, J. A.; Zepeda, L.; Carpenter, Q.

    2010-12-01

    Since 2007 a workshop class of University of Wisconsin-Madison students has participated in a community-based project in New Orleans to investigate the feasibility of restoring the Bayou Bienvenue Wetland Triangle (BBWT), which is adjacent to the Lower 9th Ward in New Orleans. This 440-acre region is currently open water but was a cypress forest until the 1970s. Restoration would provide protection from storm surges, restored ecological services, and recreational use. The workshop introduced students to the multidisciplinary skills needed to work effectively with the complex and interconnected issues within a project involving many stakeholders. The stakeholders included the Center for Sustainable Engagement and Development (CSED), Lower 9th Ward residents, non-profits (e.g., Sierra Club, Environmental Defense, Lake Pontchartrain Basin Foundation, National Wildlife Federation), government agencies (e.g., New Orleans Sewerage and Water Board, Army Corps of Engineers), neighborhood groups (e.g., Holy Cross Neighborhood Association, The Village), and universities (Tulane, U. of New Orleans, LSU, U. Colorado-Denver, Southeastern Louisiana). The course ran initially as a Water Resources Management practicum in the first two summers and then as a broader multidisciplinary project with student expertise in hydrology, social science, law, planning, policy analysis, community development, GIS, public health, environmental education and ecological restoration. The project divided into three main components: wetland science, social science, and land tenure and planning. Principal activities in wetland science were to monitor water levels and water quality, inventory flora and fauna, and plant grasses on small “floating islands.” The principal social science activity was to conduct a neighborhood survey about knowledge of the wetland and interest in its restoration. The land tenure and planning activity was to investigate ownership and transfer of property within the

  5. QUALIMETRIC ESTIMATION OF INTEGRATION OF RESEARCHERS INTO THE SCIENTIFIC COMMUNITY, BASED ON THE ANALYSIS OF CITATIONS

    Directory of Open Access Journals (Sweden)

    Loyko V. I.

    2016-04-01

    Full Text Available The article presents the criteria for evaluating the integration of researchers in the scientific community, based on an analysis of its citations. It is known, that one of the major components of interscientific communication (communication in the scientific community is a citation of scientific publications (monographs, articles, etc.. According to the sociological approach, a scientist is a part of society, ie, scientific community; under scientific community we understand scientific mega environment (opposed to research groups of institutions and their structural units. Integration of a researcher to the community has many aspects: on the one hand, it is - the importance of his work to the scientific community, on the other hand, it is - the use of a scientist social mega environment for building for their personal and professional development to improve their research and improve the quality of its results (in the context of the article we will consider the second aspect. Methodological bases of the research: systematic, competence, sociological, and mega-system qualimetric approaches. Methods: modeling, methods of quality control, methods of set theory, relations and graphs. Evaluation (diagnostics involvement of scientists in the scientific community - is more complicated metrology task than the evaluation of the significance of the results of its research activities. For the authors it is clear that a mature scientist (with a high level of research competence should intensively use the potential of the social and the cultural science international environment (community for their personal and professional development, to improve the efficiency of this research activities and the quality of this results. The proposed indicators can be considered as group indicator variables reflecting the level of the behavioral component of the research competence (scientist. Using social media for researcher’s potential – it is necessary, but not

  6. Fractional Pure Birth Processes

    CERN Document Server

    Orsingher, Enzo; 10.3150/09-BEJ235

    2010-01-01

    We consider a fractional version of the classical non-linear birth process of which the Yule-Furry model is a particular case. Fractionality is obtained by replacing the first-order time derivative in the difference-differential equations which govern the probability law of the process, with the Dzherbashyan-Caputo fractional derivative. We derive the probability distribution of the number $ \\mathcal{N}_\

  7. Wrongful life and birth.

    Science.gov (United States)

    Evgenia, Smyrnaki

    2012-03-01

    The main scope of the article is the bioethical and legal issues of wrongful birth and wrongful life with reference to doctors' medical liability. Nowadays, prenatal tests tend to substitute the eugenic practice of Spartan inspection to raise a strong and healthy child. Should the doctor misinform the parents that the child is healthy and the parents do not exercise the right to abort the pregnancy, the doctor can be held liable and claims on wrongful life or birth are raised against him. "Wrongful life" is an oxymoron itself since "life" which has an intrinsic value and sanctity is attributed a negative aspect and is regarded as damage. Courts around the world have awarded parents compensation on that legal ground. In the Perruche affair (2000), where the mother was wrongly diagnosed and gave birth to Nicholas, who had serious neurological problems, the court conferred the right on the child itself, causing an uproar in France. The decision was criticized for encouraging eugenics and diminishing the value of handicapped people. The different approaches to the above issues by different courts around the world (US, EU) with reference to (bio) ethical concerns are going to be examined. We will try to give an answer on whether it is possible for courts to support on legal and bioethical grounds that a child with disabilities should not have been born as a result of the doctor's negligent conduct. In such cases, the limits of normality and the value of life are challenged

  8. Teen Smoking and Birth Outcomes

    OpenAIRE

    MaryBeth Walker; Erdal Tekin; Sally Wallace

    2007-01-01

    In the U.S. teen mothers are more likely to give birth to low birth weight babies than non-teen mothers. There is also substantial evidence that smoking is a risk factor correlated with low birth weight. Low birth weight is a costly outcome in both the short and long term for parents, children, and society at large. This paper examines the causal link between teen age smoking behavior and low birth weight. We use a variety of empirical techniques including fixed effects and a matching estimat...

  9. Computeen: A Randomized Trial of a Preventive Computer and Psychosocial Skills Curriculum for At-Risk Adolescents

    Science.gov (United States)

    Lang, Jason M.; Waterman, Jill; Baker, Bruce L.

    2009-01-01

    Computeen, a preventive technology and psychosocial skills development program for at-risk adolescents, was designed to improve computer skills, self-esteem, and school attitudes, and reduce behavior problems, by combining elements of community-based and empirically supported prevention programs. Fifty-five mostly Latino adolescents from 12 to 16…

  10. A Multisector Framework for Assessing Community-Based Forest Management: Lessons from Madagascar

    Directory of Open Access Journals (Sweden)

    Daniela B. Raik

    2007-06-01

    Full Text Available Community-based forest management has proliferated throughout Africa as national governments have decentralized the administration of public forestry. Community-based forestry has taken multiple forms, depending on the assortment of land-tenure systems, forest-use norms, wood demand, and social organization, among others factors. Nature, Wealth, and Power is an analytical framework that has been developed from experiences in natural resource management in Africa. In this paper, we amend the framework to People, Nature, Wealth, and Power (PNWP, and propose it as an analytical lens for community-based forest management initiatives. We use the PNWP framework to assess the responsiveness of contractual forest management in the Menabe region of Madagascar to the interests of local communities, the state forest agency, and conservation nongovernmental organizations. Findings indicate that members of each of the three groups hold some differing interests, which may result in conflict over time. Specifically, interests converge around the Nature and Wealth categories and diverge around the People and Power categories. Also, the contract mechanism for community-based forest management currently being implemented in Menabe does not account for the People and Wealth interests held by any of the three groups. More research is needed, but our inquiry indicates the PNWP framework holds promise for assessing community-based forest management initiatives.

  11. Assessing the impact of community-based mobile crisis services on preventing hospitalization.

    Science.gov (United States)

    Guo, S; Biegel, D E; Johnsen, J A; Dyches, H

    2001-02-01

    This study evaluated the impact of a community-based mobile crisis intervention program on the rate and timing of hospitalization. It also explored major consumer characteristics related to the likelihood of hospitalization. A quasi-experimental design with an ex post matched control group was used. A community-based mobile crisis intervention cohort (N=1,696) was matched with a hospital-based intervention cohort (N=4,106) on seven variables: gender, race, age at the time of crisis service, primary diagnosis, recency of prior use of services, indication of substance abuse, and severe mental disability certification status. The matching process resulted in a treatment group and a comparison group, each consisting of 1,100 subjects. Differences in hospitalization rate and timing between the two groups were assessed with a Cox proportional hazards model. The community-based crisis intervention reduced the hospitalization rate by 8 percentage points. A consumer using a hospital-based intervention was 51 percent more likely than one using community-based mobile crisis services to be hospitalized within the 30 days after the crisis (phomeless, and experiencing acute problems; they were referred by psychiatric hospitals, the legal system, or other treatment facilities; they showed signs of substance abuse, had no income, and were severely mentally disabled. Results indicate that community-based mobile crisis services resulted in a lower rate of hospitalization than hospital-based interventions. Consumer characteristics were also associated with the risk of hospitalization.

  12. ASCO's Community Research Forum: addressing challenges of community-based research from the grass roots.

    Science.gov (United States)

    Robert, Nicholas; Lilenbaum, Rogerio; Hurley, Patricia

    2014-01-01

    ASCO's Community Research Forum is a solution-oriented venue for community research sites to overcome barriers to conducting clinical trials. The key objectives of the Forum are to (1) convene community-based researchers to identify challenges to conducting research that ASCO can address, (2) develop solution-oriented projects to address these challenges to facilitate clinical trial participation in community research settings, and (3) shape ASCO programs and policies to support members engaged in community research. The Community Research Forum holds an annual in-person meeting that convenes physician investigators, research administrators, research nurses, and clinical research associates from community-based research programs and practices. To meet identified needs, the Community Research Forum has developed the ASCO Clinical Trial Workload Assessment Tool and the ASCO Research Program Quality Assessment Tool. Both of these tools will be available to the public in 2014. The Forum is currently exploring the concept and potential metrics of a research certification program to formally assess community-based research programs, and to identify gaps and areas to improve the program in order to meet quality standards. The Community Research Forum's website aims to serve as a go-to resource for community-based physician investigators and research staff. The Community Research Forum will continue to provide a forum for community-based researchers to network, share challenges, and develop initiatives that provide solutions and facilitate the conduct of clinical trials.

  13. Employing continuous quality improvement in community-based substance abuse programs.

    Science.gov (United States)

    Chinman, Matthew; Hunter, Sarah B; Ebener, Patricia

    2012-01-01

    This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community-based organization setting. CQI (e.g., plan-do-study-act cycles (PDSA)) applied in healthcare and industry was adapted for substance abuse prevention and treatment programs in a community setting. The authors assessed the resources needed, acceptability and CQI feasibility for ten programs by evaluating CQI training workshops with program staff and a series of three qualitative interviews over a nine-month implementation period with program participants. The CQI activities, PDSA cycle progress, effort, enthusiasm, benefits and challenges were examined. Results indicated that CQI was feasible and acceptable for community-based substance abuse prevention and treatment programs; however, some notable resource challenges remain. Future studies should examine CQI impact on service quality and intended program outcomes. The study was conducted on a small number of programs. It did not assess CQI impact on service quality and intended program outcomes. Practical implications- This project shows that it is feasible to adapt CQI techniques and processes for community-based programs substance abuse prevention and treatment programs. These techniques may help community-based program managers to improve service quality and achieve program outcomes. This is one of the first studies to adapt traditional CQI techniques for community-based settings delivering substance abuse prevention and treatment programs.

  14. Implementing community-based education in basic nursing education programs in South Africa

    Directory of Open Access Journals (Sweden)

    N.G. Mtshali

    2009-09-01

    Full Text Available Education of health professionals using principles of community-based education is the recommended national policy in South Africa. A paradigm shift to community based education is reported in a number of nursing education institutions in South Africa. Reviewed literature however revealed that in some educational institutions planning, implementation and evaluation of Community-based Educational (CBE programmes tended to be haphazard, uncoordinated and ineffective, resulting in poor student motivation. Therefore the purpose of this study was to analyse the implementation of community-based education in basic nursing education programmes in South Africa. Strauss and Corbin’s (1990 grounded theory approach guided the research process. Data were collected by means of observation, interviews and document analysis. The findings revealed that collaborative decision-making involving all stakeholders was crucial especially during the curriculum planning phase. Furthermore, special criteria should be used when selecting community learning sites to ensure that the selected sites are able to facilitate the development of required graduate competencies. Collaborative effort, true partnership between academic institutions and communities, as well as government support and involvement emerged as necessary conditions for the successful implementation of community-based education programmes.

  15. Home birth attendants in low income countries: who are they and what do they do?

    Directory of Open Access Journals (Sweden)

    Garces Ana

    2012-05-01

    Full Text Available Abstract Background Nearly half the world’s babies are born at home. We sought to evaluate the training, knowledge, skills, and access to medical equipment and testing for home birth attendants across 7 international sites. Methods Face-to-face interviews were done by trained interviewers to assess level of training, knowledge and practices regarding care during the antenatal, intrapartum and postpartum periods. The survey was administered to a sample of birth attendants conducting home or out-of-facility deliveries in 7 sites in 6 countries (India, Pakistan, Guatemala, Democratic Republic of the Congo, Kenya and Zambia. Results A total of 1226 home birth attendants were surveyed. Less than half the birth attendants were literate. Eighty percent had one month or less of formal training. Most home birth attendants did not have basic equipment (e.g., blood pressure apparatus, stethoscope, infant bag and mask manual resuscitator. Reporting of births and maternal and neonatal deaths to government agencies was low. Indian auxilliary nurse midwives, who perform some home but mainly clinic births, were far better trained and differed in many characteristics from the birth attendants who only performed deliveries at home. Conclusions Home birth attendants in low-income countries were often illiterate, could not read numbers and had little formal training. Most had few of the skills or access to tests, medications and equipment that are necessary to reduce maternal, fetal or neonatal mortality.

  16. The birthing experiences of rural Aboriginal women in context: implications for nursing.

    Science.gov (United States)

    Brown, Helen; Varcoe, Colleen; Calam, Betty

    2011-12-01

    It has been established that the birthing experiences and outcomes of rural women are shaped by poverty, isolation, limited economic opportunities, and diminishing maternity services. We lack research into how these dynamics are compounded by intersecting forms of oppression faced by Aboriginal women, to impact on their birthing experiences and outcomes. The findings of this study of rural Aboriginal maternity care in 4 communities in British Columbia show how diminishing local birthing choices and women's struggles to exert power, choice, and control are influenced by centuries of colonization. The research questions focus on rural Aboriginal women's experiences of birthing and maternity care in this neocolonial context and their desire for supportive birthing environments. A community-based participatory and ethnographic design was employed. Individual interviews, focus groups, and participant observation were the primary data sources. Although the women's experiences in each community were shaped by distinct histories and traditions, economics, politics, and geographies, the impacts of colonization and medical paternalism and the struggle for control of women's bodies during birth intersect, placing additional stress on women. The implications for nurses of accounting for the intersecting dynamics that shape Aboriginal women's experiences and birth outcomes are discussed.

  17. Adaptive Management and Social Learning in Collaborative and Community-Based Monitoring: a Study of Five Community-Based Forestry Organizations in the western USA

    Directory of Open Access Journals (Sweden)

    Heidi L. Ballard

    2008-12-01

    Full Text Available Collaborative and community-based monitoring are becoming more frequent, yet few studies have examined the process and outcomes of these monitoring approaches. We studied 18 collaborative or community-based ecological assessment or monitoring projects undertaken by five community-based forestry organizations (CBFs, to investigate the objectives, process, and outcomes of collaborative ecological monitoring by CBF organizations. We found that collaborative monitoring can lead to shared ecological understanding among diverse participants, build trust internally and credibility externally, foster social learning and community-building, and advance adaptive management. The CBFs experienced challenges in recruiting and sustaining community participation in monitoring, building needed technical capacity for monitoring, and communicating monitoring results back to the broader community. Our results suggest that involving diverse and sometimes adversarial interests at key points in the monitoring process can help resolve conflicts and advance social learning, while also strengthening the link between social and ecological systems by improving the information base for management and increasing collective awareness of the interdependence of human and natural forest communities.

  18. Consistency with evidence-based treatments and perceived effectiveness of children's community-based care.

    Science.gov (United States)

    Haine-Schlagel, Rachel; Fettes, Danielle L; Garcia, Antonio R; Brookman-Frazee, Lauren; Garland, Ann F

    2014-02-01

    This study examined whether delivery of psychotherapeutic strategies consistent with common elements of evidence-based (EB) treatments for child disruptive behavior problems was associated with parents' report of treatment effectiveness. The intensity of delivery of practice elements consistent with EB treatments was coded from a random sample of 538 videotaped psychotherapy sessions with 157 children/families and 75 therapists from six community-based clinics. Multilevel regression analyses tested whether intensity of EB practice elements was associated with parents' report of treatment effectiveness after 4 months, controlling for intensity of other practice elements. Results indicate parents reported greater perceived treatment effectiveness when community-based treatment included more intensive delivery of practice elements consistent with EB treatments to children. These findings may reassure providers about the acceptability of EB practice elements and may motivate efforts to integrate EB practice elements more intensively into community-based care.

  19. [Extension of health coverage and community based health insurance schemes in Africa: Myths and realities].

    Science.gov (United States)

    Boidin, B

    2015-02-01

    This article tackles the perspectives and limits of the extension of health coverage based on community based health insurance schemes in Africa. Despite their strong potential contribution to the extension of health coverage, their weaknesses challenge their ability to play an important role in this extension. Three limits are distinguished: financial fragility; insufficient adaptation to characteristics and needs of poor people; organizational and institutional failures. Therefore lessons can be learnt from the limits of the institutionalization of community based health insurance schemes. At first, community based health insurance schemes are to be considered as a transitional but insufficient solution. There is also a stronger role to be played by public actors in improving financial support, strengthening health services and coordinating coverage programs.

  20. Applying community-based participatory research to better understand and improve kinship care practices

    DEFF Research Database (Denmark)

    Chukwudozie, Oge; Feinstein, Clare; Jensen, Celina;

    2015-01-01

    While the principles behind community-based participatory research are firmly established, the process of taking community-based participatory research with children and youth to scale and integrating it into the programming of non-governmental organizations has been scarcely documented....... This article reflects on the experiences of Save the Children in implementing a multicountry community-based participatory research program to increase understanding of kinship care in the Democratic Republic of Congo, Nigeria, and Sierra Leone. The article discusses challenges faced and lessons learned...... and highlights how the research process enabled action and advocacy initiatives at different levels-leading to an increase in support and policy attention for children living in kinship care....

  1. Developing community based rehabilitation for cancer survivors: Organizing for coordination and coherence in practice

    DEFF Research Database (Denmark)

    la Cour, Karen; Cutchin, Malcolm

    2013-01-01

    Background. Increasing incidence of cancer combined with prolonged survival have raised the need for developing community based rehabilitation. The objectives of the analysis were to describe and interpret the key issues related to coordination and coherence of community-based cancer rehabilitation....... A Grounded Theory approach was used to analyze the data. Results. A lack of shared cultures among health care providers and systems of delivery was a primary barrier to collaboration which was essential for establishing coordination of care. Formal multidisciplinary steering committees, team......-based organization, and informal relationships were fundamental for developing coordination and coherence. Conclusions. Coordination and coherence in community-based rehabilitation relies on increased collaboration, which may best be optimized by use of shared frameworks within and across systems. Results highlight...

  2. Taenia solium taeniasis and cysticercosis control and elimination through community-based interventions.

    Science.gov (United States)

    Carabin, Hélène; Traoré, Aminata A

    2014-12-01

    Taenia solium was declared potentially eradicable by the International Task Force for Disease Eradication in 1992. Yet, very few well-designed community-based randomized controlled trials have been conducted to measure the effectiveness of alternative control strategies. Most strategies have been tested in pre-post intervention designs in very few communities, often without a control group. The only two community-based randomized controlled trials suggest that an educational program alone or a combination of human and porcine mass treatment reduce porcine cysticercosis in the short term. A transmission dynamics model suggests that improved sanitation and pig management are more effective and sustainable than pig vaccination, human or porcine mass treatment. Current evidence does not support the eradication of Taenia solium in the foreseeable future. Investigators should follow international recommendations on the conduct of community-based randomized control trials to provide more valid estimates of the effect and cost-effectiveness of alternative control strategies for cysticercosis.

  3. Trends in Antibiotic Use by Birth Season and Birth Year.

    Science.gov (United States)

    Kinlaw, Alan C; Stürmer, Til; Lund, Jennifer L; Pedersen, Lars; Kappelman, Michael D; Daniels, Julie L; Frøslev, Trine; Mack, Christina D; Sørensen, Henrik Toft

    2017-09-01

    We examined 2 birth cohort effects on antibiotic prescribing during the first year of life (henceforth, infancy) in Denmark: (1) the birth season effect on timing and overall occurrence of antibiotic prescribing, and (2) the birth year effect amid emerging nationwide pneumococcal vaccination programs and changing prescribing guidelines. We linked data for all live births in Denmark from 2004 to 2012 (N = 561 729) across the National Health Service Prescription Database, Medical Birth Registry, and Civil Registration System. Across birth season and birth year cohorts, we estimated 1-year risk, rate, and burden of redeemed antibiotic prescriptions during infancy. We used interrupted time series methods to assess prescribing trends across birth year cohorts. Graphical displays of all birth cohort effect data are included. The 1-year risk of having at least 1 redeemed antibiotic prescription during infancy was 39.5% (99% confidence interval [CI]: 39.3% to 39.6%). The hazard of a first prescription increased with age throughout infancy and varied by season; subsequently, Kaplan-Meier-derived risk functions varied by birth season cohort. After rollout of a first vaccination program and new antibiotic prescribing guidelines, 1-year risk decreased by 4.4% over 14 months (99% CI: 3.4% to 5.5%); it decreased again after rollout of a second vaccination program by 6.9% over 3 years (99% CI: 4.4% to 9.3%). In Denmark, birth season and birth year cohort effects influenced timing and risk of antibiotic prescribing during infancy. Future studies of antibiotic stewardship, effectiveness, and safety in children should consider these cohort effects, which may render some children inherently more susceptible than others to downstream antibiotic effects. Copyright © 2017 by the American Academy of Pediatrics.

  4. Birth rites: redefining the visual language of birth.

    Science.gov (United States)

    Uppal, Elaine

    2011-02-01

    This article provides a review of a Birth Rites organisation event to launch its new website and art competition. Birth Rites is the first and only collection of contemporary artwork dedicated to the subject of childbirth. The collection aims to redefine visual language in contemporary art around the subject of birth, making women the protagonists, with more choice and a greater understanding of the process. The organisation was founded by two women, Phoebe Mortimer and curator Helen Knowles.

  5. IMPACT OF SOCIAL CAPITAL CHARACTERISTICS ON THE EFFECTIVENESS OF COMMUNITY-BASED APPROACH TO LOCAL DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    N. Grazhevska

    2013-10-01

    Full Text Available The article examines the impact of social capital characteristics of local communities on the effectiveness of the community-based approach to economic development. The conclusion that such social capital characteristics as (antipaternalism, solidarity and cooperation have the greatest importance for the economic development is made based on the analysis of UNDP and the European Union project “Community-based approach to local development”. It was hypothesized that the creation of community organizations could be an effective mechanism to actualize the existing social capital of rural communities in Ukraine.

  6. The local community development and the community-based tourism : a comparative conceptual analysis

    Directory of Open Access Journals (Sweden)

    Sylvie PARENT

    2009-01-01

    Full Text Available According to the authors of this paper, mass tourism does not generate the development of local communities but rather their devitalization. This paper presents a cross-literature survey on community-based tourism and local community development. It proposes some links between these two approaches and asserts that community-based tourism can be a strategy to trigger local community development. It address the conditions under which the convergence of these two approaches may allow the launching of development initiatives liable to counter the devitalization and impoverishment process which characterizes certain mass tourism oriented places.

  7. Using Promotores Programs to Improve Latino Health Outcomes: Implementation Challenges for Community-based Nonprofit Organizations.

    Science.gov (United States)

    Twombly, Eric C; Holtz, Kristen D; Stringer, Kimberly

    2012-05-01

    Promotores are community lay health workers, who provide outreach and services to Latinos. Little research on the promotores programs exists and the focus of this article is to identify the challenges faced by community-based nonprofits when implementing promotores programs. To explore this type of program telephone interviews were conducted with ten promotores academic experts and nonprofit executives. The results suggest that implementation challenges fall into three major categories: the lack of standardized information on promotores programs, labor issues, and organizational costs. Future recommendations are made which highlight promotores recruitment and retention strategies, and the development of a clearinghouse of programmatic implementation information for community-based nonprofits.

  8. Use of preventive measures of childhood injuries at household level: Community-based findings from Nepal

    OpenAIRE

    Pant, P. R.; Towner, E.; Ellis, M; Pilkington, P.

    2013-01-01

    Introduction: Child injuries are a major public health problem in low- and middle- income countries but they are\\ud not recognised at policy or community level. Prevention of injuries is neglected due to lack of awareness. Only a\\ud few community-based studies have been conducted to explore this problem.\\ud Objectives: To explore the practice of safety measures applied by the household after childhood injury among the\\ud survey households of Makwanpur.\\ud Methods: A community-based household ...

  9. Nourishing a partnership to improve middle school lunch options: a community-based participatory research project.

    Science.gov (United States)

    Reich, Stephanie M; Kay, Joseph S; Lin, Grace C

    2015-01-01

    Community-based participatory research is predicated on building partnerships that tackle important issues to the community and effectively improve these issues. Community-based participatory research can also be an empowering experience, especially for children. This article describes a university-community partnership in which students at a low-income middle school worked to improve the quality of the cafeteria food provided to the 986 students eligible for free and reduced price lunches. The project led to menu changes, improved communication between youth, school administrators, and district staff, and enabled youth to enact school improvements that were beneficial for their health.

  10. Leadership Skills

    Science.gov (United States)

    Parish, Thomas S.

    2006-01-01

    While this may not be a "complete list" of what leadership skills one needs to effectively lead in any/every situation, it should provide a great overview of many of the things s/he needs to do, at least initially.

  11. Coping Skills.

    Science.gov (United States)

    Library of Congress, Washington, DC. National Library Service for the Blind and Physically Handicapped.

    This annotated bibliography lists approximately 150 braille books and 300 audiocassettes of books which address coping skills for people in a variety of situations. All items listed are available in the network library collections provided by the National Library Service for the Blind and Physically Handicapped of the Library of Congress.…

  12. Birth weight and stuttering: Evidence from three birth cohorts.

    Science.gov (United States)

    McAllister, Jan; Collier, Jacqueline

    2014-03-01

    Previous studies have produced conflicting results with regard to the association between birth weight and developmental stuttering. This study sought to determine whether birth weight was associated with childhood and/or adolescent stuttering in three British birth cohort samples. Logistic regression analyses were carried out on data from the Millenium Cohort Study (MCS), British Cohort Study (BCS70) and National Child Development Study (NCDS), whose initial cohorts comprised over 56,000 individuals. The outcome variables were parent-reported stuttering in childhood or in adolescence; the predictors, based on prior research, were birth weight, sex, multiple birth status, vocabulary score and mother's level of education. Birth weight was analysed both as a categorical variable (low birth weight, stuttering during childhood (age 3, 5 and 7 and MCS, BCS70 and NCDS, respectively) or at age 16, when developmental stuttering is likely to be persistent. None of the multivariate analyses revealed an association between birth weight and parent-reported stuttering. Sex was a significant predictor of stuttering in all the analyses, with males 1.6-3.6 times more likely than females to stutter. Our results suggest that birth weight is not a clinically useful predictor of childhood or persistent stuttering. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. Perceptions of Obvious and Disruptive Climate Change: Community-Based Risk Assessment for Two Native Villages in Alaska

    Directory of Open Access Journals (Sweden)

    Jon Rosales

    2015-10-01

    Full Text Available This work operationalizes the determinants of climate change risk, exposure and vulnerability, through the perceptions held by Native hunters, fishers, and gatherers in Savoonga and Shaktoolik, Alaska. Informed by their skill, experience, and the traditional knowledge of their elders, hunters, fishers, and gatherers in these communities are astute observers of their environment and environmental change. A questionnaire is used to sort and rank their perceptions of the most obvious and disruptive elements of climate change as representations of exposure and vulnerability, respectively. Results represent the relative strength and significance of those perceptions of environmental change. In addition to other changes, storms are among the most obvious and disruptive impacts of climate change to respondents in both communities, while changes to sea ice tend to be more disruptive in Savoonga, a more ice-obligate culture, than Shaktoolik. Changes on the tundra are more obvious in Shaktoolik, but is the least disruptive category of change in both villages. Changes along the coast were both obvious and disruptive, albeit more so in Shaktoolik than Savoonga. The findings suggest that traditional ecological knowledge is a valuable source of information to access perceptions of risk, and develop climate risk management and adaptation plans. The questionnaire design and statistical methodology may be of interest to those working on community-based adaptation and risk assessment projects in high-risk, poor, and marginalized Native communities with small populations.

  14. Engaging cultural resources to promote mental health in Dutch LSES neighborhoods: study of a community-based participatory media project.

    Science.gov (United States)

    Knibbe, Mare; de Vries, Marten; Horstman, Klasien

    2015-09-28

    Community-based participatory media projects form a promising new strategy for mental health promotion that can help address the mental health-gap identified by the World Health Organization. (2008b) mhGAP, Mental Health Gap Action Programme: Scaling Up Care for Mental, Neurological and Substance Use Disorders. World Health Organization, Geneva. In this article we present an ethnographic study about a participatory media project that was developed to promote mental health in selected Dutch low socio-economic status neighborhoods. Through narrowcastings (group film viewings), participant observation and interviews we mapped the ways in which the media project effected and facilitated the collective sense-making process of the audience with regard to sources of stress impacting mental health and opportunities for action. These determinants of mental health are shaped by cultural dimensions, since the cultural context shapes everyday experiences of stress as well as the resources and skills to manage them. Our analysis shows that the media project engaged cultural resources to challenge stressful social scripts. We conclude that more attention should be paid to cultural narratives in a community to understand how health promotion strategies can support social resilience.

  15. Reforms from the Ground Up: A Review of Community-Based Forest Management in Tropical Developing Countries

    Science.gov (United States)

    Tole, Lise

    2010-06-01

    After an initial burst of enthusiasm in the 1990s, community-based forest management (CBFM) is increasingly being viewed with a critical eye. Evidence suggests that many programs have failed to promote their stated objectives of sustainability, efficiency, equity, democratic participation and poverty reduction. A large volume of academic literature now exists on CBFM, examining both the success and failure of such initiatives in a wide variety of countries. Through analysis of key themes, concepts and issues in CBFM, this article provides a review of CBFM initiatives in tropical developing countries for policymakers, practitioners and planners wishing to gain an understanding of this wide-ranging, interdisciplinary academic literature. The article identifies key institutions and incentives that appear to significantly affect the success or failure of CBFM initiatives. In particular, it reports that consideration of institutional and socioeconomic factors along with personal characteristics of key stakeholders such as beliefs, attitudes, financial resources and skills are important determinants of CBFM outcomes. However, local incentive structures also appear to be important. There is increasing recognition in the literature of the need to consider the conditions under which local politicians entrusted with carrying out CBFM initiatives will deem it worthwhile to invest their scarce time and resources on environmental governance.

  16. Healthcare access and quality of birth care: narratives of women living with obstetric fistula in rural Tanzania

    OpenAIRE

    2016-01-01

    Background Increasing births with skilled attendants and increasing health facilities with Emergency Obstetric Care (EmOC) can reduce maternal mortality and are considered critical interventions for ensuring safe motherhood. Despite Tanzania’s policy to support women to give birth with the assistance of skilled personnel, some women do not access this care. This article uses women’s stories to illustrate the challenges that caused them to fail to access adequate obstetric care in a timely man...

  17. The Birth of Matter

    CERN Multimedia

    2005-01-01

    To mark the World Year of Physics, the Physics Section of the University of Geneva is organising a series of lectures for the uninitiated. Each lecture will begin with a demonstration in the auditorium of the detection of cosmic rays and, in collaboration with Professor E. Ellberger of the Conservatoire de Musique de Genève, of how these signals from the farthest reaches of the Universe can be used to create 'cosmic music'. The fourth lecture in the series, entitled 'The Birth of Matter', will take place on Tuesday 3 May 2005 and will be given by CERN's theoretical physicist, John Ellis. Where does matter come from? Where do the structures that surround us, such as galaxies, come from? Are we living in a world of invisible matter? Why is the universe so old and so big? John Ellis will show how elementary particle physics and, in particular, the LHC under construction at CERN, can answer these questions. The Birth of Matter Professor John Ellis Tuesday 3 May, starting 8.00 p.m. Main Auditorium...

  18. The Birth of Matter

    CERN Multimedia

    2005-01-01

    To mark the World Year of Physics, the Physics Section of the University of Geneva is organising a series of lectures for the uninitiated. Each lecture will begin with a demonstration in the auditorium of the detection of cosmic rays and, in collaboration with Professor E. Ellberger of the Conservatoire de Musique de Genève, of how these signals from the farthest reaches of the Universe can be used to create "cosmic music". The fourth lecture in the series, entitled "The Birth of Matter", will take place on Tuesday 3 May 2005 and will be given by CERN's theoretical physicist, John Ellis. Where does matter come from? Where do the structures that surround us, such as galaxies, come from? Are we living in a world of invisible matter? Why is the universe so old and so big? John Ellis will show how elementary particle physics and, in particular, the LHC under construction at CERN, can answer these questions. The Birth of Matter Professor John Ellis Tuesday 3 May, starting 8.00 p.m. Main Audito...

  19. Birth after cesarean section

    Science.gov (United States)

    Velemínský, Miloš; Velemínský, Miloš; Piskorzová, Martina; Bašková, Martina; Tóthová, Valérie; Stránský, Pravoslav

    2011-01-01

    Summary Background The number of incoming expectant women who have previously experienced cesarean section has increased. This work sought to find the frequency and connections between vaginal deliveries, cesarean sections, and iterative cesarean sections from 2004 to 2008. Material/Methods In all, 828 women with previous cesarean sections were included. From this group, 8282 vaginal deliveries were performed. During these years, 828 women had a history of the cesarean section; in these women, iterative cesarean sections were indicated. To evaluate knowledge of educational material designed for women being prepared for the iterative delivery, we used information compiled on experience from 2002 to 2003; the same approach was used to evaluate the nursing process on interventions and diagnoses of cesarean sections. Results From 2004 to 2008, 11 279 deliveries were performed in the Perinatological Center in České Budějovice; this was significant (Pcesarean section. The number of iterative cesarean sections in women who had already experienced the cesarean section (828) and delivered by cesarean section again is 620. Other data were not significant. Only 2 to 3 pregnancies next to the first cesarean section were statistically significant in 2004 and 2005. Conclusions If a trial of labor after cesarean does not proceed to vaginal birth, the woman will need support and encouragement to express feelings about another cesarean birth. PMID:21278695

  20. Popular Research and Social Transformation: A Community-Based Approach to Critical Pedagogy.

    Science.gov (United States)

    Rivera, Klaudia M.

    1999-01-01

    Focuses on the application of critical pedagogy at El Barrio Popular Education Program, a community-based adult-education program in New York City. Committed to the development of bilingualism and biliteracy, the program integrated Spanish-language literacy and basic education with English as a Second Language, computer and video technology, and…

  1. Community-Based English Clubs: English Practice and Social Change outside the Classroom

    Science.gov (United States)

    Malu, Kathleen F.; Smedley, Bryce

    2016-01-01

    This article defines and provides a rationale for the creation of community-based English clubs. We offer strategies that individuals can use to create and sustain English clubs, and we suggest meeting activities that will engage members in conversations and potential community action on a range of topics such as democracy, gender equality, and…

  2. Strategic framework for socioeconomic viability of community-based early warning system

    NARCIS (Netherlands)

    Homberg, M.J.C. van den; Posthumus, A.L.

    2014-01-01

    Christian Aid, Cordaid, PVGS and Practical Action established a community-based early warning system for cross-border floods between India and Nepal in 45 Indian villages. The project will scale to 95 villages early 2016. The number of stakeholders and organizational levels of this system with four

  3. Community based fish culture in the public and private floodplains of Bangladesh

    NARCIS (Netherlands)

    Mahfuzul Haque, A.B.

    2015-01-01

    Seasonal floodplains are water bodies that retain water for 5-6 months during which they are suitable to grow fish and other aquatic animals. Out of 2.8 million ha of medium and deep-flooded areas, about 1.5 million ha are estimated to be suitable for Community-Based Fish Culture (CBFC). WorldFish h

  4. Our Environment, Our Health: A Community-Based Participatory Environmental Health Survey in Richmond, California

    Science.gov (United States)

    Cohen, Alison; Lopez, Andrea; Malloy, Nile; Morello-Frosch, Rachel

    2012-01-01

    This study presents a health survey conducted by a community-based participatory research partnership between academic researchers and community organizers to consider environmental health and environmental justice issues in four neighborhoods of Richmond, California, a low-income community of color living along the fence line of a major oil…

  5. A Community-Based Approach for Integrating Geriatrics and Gerontology into Undergraduate Medical Education

    Science.gov (United States)

    Martinez, Iveris L.; Mora, Jorge Camilo

    2012-01-01

    Medical school accreditation requirements require educational opportunities in geriatrics. Twenty-six minimum graduating competencies in geriatrics have recently been identified for medical students. The authors describe how these competencies are being integrated into a new medical curriculum through coursework and community-based experiences.…

  6. Community-Based Service-Learning as a Context for Youth Autonomy, Competence, and Relatedness

    Science.gov (United States)

    Kackar-Cam, Hayal; Schmidt, Jennifer A.

    2014-01-01

    Framed by self-determination and identity development theories, this study examined the process through which participating in a community-based service-learning project supported high school students' feelings of autonomy, competence and relatedness, and how these feelings were related to students' intentions for doing more service in…

  7. 75 FR 67751 - Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting

    Science.gov (United States)

    2010-11-03

    ... provide a forum for community-based organizations, hospitals, Quality Improvement Organizations... materials will be posted on the CMS Care Transitions Web site prior to the meeting. FOR FURTHER INFORMATION CONTACT: Juliana Tiongson, Social Science Research Analyst, Centers for Medicare & Medicaid Services,...

  8. Community Based Learning and Civic Engagement: Informal Learning among Adult Volunteers in Community Organizations

    Science.gov (United States)

    Mundel, Karsten; Schugurensky, Daniel

    2008-01-01

    Many iterations of community based learning employ models, such as consciousness raising groups, cultural circles, and participatory action research. In all of them, learning is a deliberate part of an explicit educational activity. This article explores another realm of community learning: the informal learning that results from volunteering in…

  9. Lessons from community-based payment for ecosystem service schemes: from forests to rangelands.

    Science.gov (United States)

    Dougill, Andrew J; Stringer, Lindsay C; Leventon, Julia; Riddell, Mike; Rueff, Henri; Spracklen, Dominick V; Butt, Edward

    2012-11-19

    Climate finance investments and international policy are driving new community-based projects incorporating payments for ecosystem services (PES) to simultaneously store carbon and generate livelihood benefits. Most community-based PES (CB-PES) research focuses on forest areas. Rangelands, which store globally significant quantities of carbon and support many of the world's poor, have seen little CB-PES research attention, despite benefitting from several decades of community-based natural resource management (CBNRM) projects. Lessons from CBNRM suggest institutional considerations are vital in underpinning the design and implementation of successful community projects. This study uses documentary analysis to explore the institutional characteristics of three African community-based forest projects that seek to deliver carbon-storage and poverty-reduction benefits. Strong existing local institutions, clear land tenure, community control over land management decision-making and up-front, flexible payment schemes are found to be vital. Additionally, we undertake a global review of rangeland CBNRM literature and identify that alongside the lessons learned from forest projects, rangeland CB-PES project design requires specific consideration of project boundaries, benefit distribution, capacity building for community monitoring of carbon storage together with awareness-raising using decision-support tools to display the benefits of carbon-friendly land management. We highlight that institutional analyses must be undertaken alongside improved scientific studies of the carbon cycle to enable links to payment schemes, and for them to contribute to poverty alleviation in rangelands.

  10. Touring responsibility: The trouble with ‘going local’ in community-based tourism in Thailand

    NARCIS (Netherlands)

    Sin, H.L.; Minca, C.

    2014-01-01

    This paper discusses the question of responsibility with reference to community-based tourism. Local communities are often presented by the tourist industry as an inherent value to recognize and protect. Tourists visiting distant places are thus frequently exhorted to ‘go local’ through having a ‘re

  11. Research Challenges: Implementing Standardized Outcome Measures in a Decentralized, Community-Based Residential Treatment Program

    Science.gov (United States)

    Butler, Linda S.; Little, Liza; Grimard, Andre R.

    2009-01-01

    With residential treatment services under pressure to produce outcome data, the process of executing research in such settings presents considerable challenges. This paper describes how a large, decentralized, community-based residential treatment program in southern and central Maine designed and implemented a research outcome process study using…

  12. Newspaper Content Analysis in Evaluation of a Community-Based Participatory Project to Increase Physical Activity

    Science.gov (United States)

    Granner, Michelle L.; Sharpe, Patricia A.; Burroughs, Ericka L.; Fields, Regina; Hallenbeck, Joyce

    2010-01-01

    This study conducted a newspaper content analysis as part of an evaluation of a community-based participatory research project focused on increasing physical activity through policy and environmental changes, which included activities related to media advocacy and media-based community education. Daily papers (May 2003 to December 2005) from both…

  13. Therapists' Attitudes Towards Psychotherapeutic Strategies in Community-Based Psychotherapy with Children with Disruptive Behavior Problems

    OpenAIRE

    Brookman-Frazee, Lauren; Garland, Ann F.; Taylor, Robin; Zoffness, Rachel

    2008-01-01

    Little is known about what individual treatment strategies therapists providing usual care psychotherapy consider the most valuable to their practice. The Therapeutic Strategies Survey (TSS) assesses therapists' attitudes about the value of 27 individual treatment strategies in their practice with children with disruptive behavior problems in community-based outpatient psychotherapy. Findings indicate that therapists from multiple professional disciplines highly value many individual psychoth...

  14. Melding Infant Mental Health and Multisystemic Therapy Approaches to Community-Based Treatment

    Science.gov (United States)

    Willoughby, Jay C.; Carubia, Beau A.; Murgolo, Marisa A.; Carter, Debbie R.; Frankel, Karen A.

    2013-01-01

    A recent partnership between the Irving Harris Program in Child Development and Infant Mental Health and the Community Based Psychiatry Program at University of Colorado Hospital joined two different approaches to child mental health treatment: infant mental health and multisystemic therapy (MST). This article illustrates the compatibility of…

  15. Erecting Closets and Outing Ourselves: Uncomfortable Reflexivity and Community-Based Research

    Science.gov (United States)

    Reed, Sarah J.; Miller, Robin Lin; Nnawulezi, Nkiru; Valenti, Maria T.

    2012-01-01

    Feminist scholars and community psychologists have argued that reflexivity is a necessary component to conducting socially conscious research. Reflexivity, however, is rarely evident in community psychology. In this article, we share the uncomfortable realities that surfaced during a community-based research project in which we adapted and…

  16. Public health impact of community-based nutrition and lifestyle interventions

    NARCIS (Netherlands)

    Verheijden, M.W.; Kok, F.J.

    2005-01-01

    Community-based interventions have increasingly received attention since researchers and public health professionals have come to acknowledge the importance of an environment that makes the healthy choice the easy choice. All stakeholders including the target community are involved to achieve change

  17. Community-Based Vocational Education: Guidelines for Complying with the Fair Labor Standards Act.

    Science.gov (United States)

    Simon, Marlene; Halloran, William

    1994-01-01

    This paper describes guidelines issued by the U.S. departments of Education and Labor to ensure that community-based vocational education programs operate in compliance with the Fair Labor Standards Act. Federal guidelines are clarified in terms of student eligibility (especially as it relates to disabilities), documentation requirements, program…

  18. Telephone-Administered Cognitive Behavioral Therapy for Veterans Served by Community-Based Outpatient Clinics

    Science.gov (United States)

    Mohr, David C.; Carmody, Timothy; Erickson, Lauren; Jin, Ling; Leader, Julie

    2011-01-01

    Objective: Multiple trials have found telephone-administered cognitive behavioral therapy (T-CBT) to be effective for the treatment of depression. The aim of this study was to evaluate T-CBT for the treatment of depression among veterans served by community-based outpatient clinics (CBOCs) outside of major urban areas. Method: Eighty-five veterans…

  19. Living Memorials: Understanding the Social Meanings of Community-Based Memorials to September 11, 2001

    Science.gov (United States)

    Erika S. Svendsen; Lindsay K. Campbell

    2010-01-01

    Living memorials are landscaped spaces created by people to memorialize individuals, places, and events. Hundreds of stewardship groups across the United States of America created living memorials in response to the September 11, 2001 terrorist attacks. This study sought to understand how stewards value, use, and talk about their living, community-based memorials....

  20. Using Community Health Workers in Community-Based Growth Promotion: What Stakeholders Think

    Science.gov (United States)

    Afulani, Patience A.; Awoonor-Williams, John K.; Opoku, Ernest C.; Asunka, Joseph

    2012-01-01

    The Nutrition and Malaria Control for Child Survival Project is a community-based growth promotion project that utilizes Community Health Workers (CHWs), referred to as Community Child Growth Promoters (CCGPs), as the principal change agents. The purpose of this study was to identify perceptions of key stakeholders about the project and the role…

  1. Understanding Program Planning Theory and Practice in a Feminist Community-Based Organization

    Science.gov (United States)

    Bracken, Susan J.

    2011-01-01

    The purpose of this article is to discuss feminist-program-planning issues, drawing from a critical ethnographic study of a Latin American feminist community-based organization. The research findings discuss the centrality of feminist identity to understanding and analyzing day-to-day program-planning process issues within a feminist…

  2. Shifting Boundaries: The Challenge of Assessing MTech Community-Based-Visual Arts Research Projects

    Science.gov (United States)

    Berman, K.

    2011-01-01

    This article aims to interrogate possible assessment problems arising from a community-based-research mode of research and consider some of the assessment approaches that generate scepticism among some examiners, and endorsement from others. The article explores specific challenges in supervising, accommodating and evaluating diverse candidates…

  3. Salsa dance and Zumba fitness: Acute responses during community-based classes

    Directory of Open Access Journals (Sweden)

    Pablo A. Domene

    2016-06-01

    Conclusion: The acute responses to classes of partnered Latin dance and non-partnered Latin-themed aerobic dance suggest that in physically inactive women participation is indeed efficacious in terms of community-based physical activity and psychosocial health promotion.

  4. Medicaid 1915(c) Home- and Community-Based Services Waivers for Children with Autism Spectrum Disorder

    Science.gov (United States)

    Velott, Diana L.; Agbese, Edeanya; Mandell, David; Stein, Bradley D.; Dick, Andrew W.; Yu, Hao; Leslie, Douglas L.

    2016-01-01

    This research aims to describe the characteristics of 1915(c) Home- and Community-Based Services waivers for children with autism spectrum disorder across states and over time. While increasingly popular, little is known about these Medicaid waivers. Understanding the characteristics of these programs is important to clinicians and policymakers in…

  5. Community-based telemonitoring for hypertension management: practical challenges and potential solutions.

    Science.gov (United States)

    Hovey, Lauren; Kaylor, Mary Beth; Alwan, Majd; Resnick, Helaine E

    2011-10-01

    Older adults residing in rural areas often lack convenient, patient-centered, community-based approaches to facilitate receipt of routine care to manage common chronic conditions. Without adequate access to appropriate disease management resources, the risk of seniors' experiencing acute events related to these common conditions increases substantially. Further, poorly managed chronic conditions are costly and place seniors at increased risk of institutionalization and permanent loss of independence. Novel, telehealth-based approaches to management of common chronic conditions like hypertension may not only improve the health of older adults, but may also lead to substantial cost savings associated with acute care episodes and institutionalization. The aim of this report is to summarize practical considerations related to operations and logistics of a unique community-based telemonitoring pilot study targeting rural seniors who utilize community-based senior centers. This article reviews the technological challenges encountered during the study and proposes solutions relevant to future research and implementation of telehealth in community-based, congregate settings.

  6. Eating Disorders among a Community-Based Sample of Chilean Female Adolescents

    Science.gov (United States)

    Granillo, M. Teresa; Grogan-Kaylor, Andrew; Delva, Jorge; Castillo, Marcela

    2011-01-01

    The purpose of this study was to explore the prevalence and correlates of eating disorders among a community-based sample of female Chilean adolescents. Data were collected through structured interviews with 420 female adolescents residing in Santiago, Chile. Approximately 4% of the sample reported ever being diagnosed with an eating disorder.…

  7. Community-Based Summer Learning Programs for School- Age Children: Research-to-Policy Resources

    Science.gov (United States)

    Stephens, Samuel A.

    2016-01-01

    Summer learning experiences for school-age children can be provided in a variety of ways and settings, including summer school programs (often remedial), community-based programs (often a continuation of afterschool programs), and home-based programs (in which families are provided with information and resources to encourage reading, often run by…

  8. Designing a Community-Based Dance Programme for North Korean Female Refugees in South Korea

    Science.gov (United States)

    Na, Kyung-Ah; Park, Hyun-Jung; Han, Seok Jin

    2016-01-01

    In this paper, we propose a community-based dance programme designed for North Korean female defectors in South Korea, with the aim of promoting their physical, psychological, and interpersonal aspects. We set up four research objectives: to look into social contexts of North Korean female refugees in South Korea, to identify the women's desire…

  9. Reflections on an Interdisciplinary, Community-Based, Team-Taught Adventure

    Science.gov (United States)

    Fauvel, Anne Marie; Miller, Lisa K.; Lane, Paul; Farris, John

    2010-01-01

    A new team-taught course focused on interdisciplinary teaching and integrative learning was offered at Grand Valley State University during the Summer of 2008 at a regional campus in Holland, Michigan. Faculty from Engineering and Business developed this community-based, alternative-format course to engage students in the question: "What will…

  10. Using ecosystem services in community-based landscape planning: science is not ready to deliver

    NARCIS (Netherlands)

    Opdam, P.F.M.

    2013-01-01

    Community-based landscape governance is considered as conditional to achieving sustainable landscape. I consider landscape governance from the point of view of adapting landscapes to create value out of ecosystem services, using the social–ecological system model as a theoretical framework. I advoca

  11. Community based fish culture in the public and private floodplains of Bangladesh

    NARCIS (Netherlands)

    Mahfuzul Haque, A.B.

    2015-01-01

    Seasonal floodplains are water bodies that retain water for 5-6 months during which they are suitable to grow fish and other aquatic animals. Out of 2.8 million ha of medium and deep-flooded areas, about 1.5 million ha are estimated to be suitable for Community-Based Fish Culture (CBFC). WorldFish h

  12. A Community-Based Approach for Integrating Geriatrics and Gerontology into Undergraduate Medical Education

    Science.gov (United States)

    Martinez, Iveris L.; Mora, Jorge Camilo

    2012-01-01

    Medical school accreditation requirements require educational opportunities in geriatrics. Twenty-six minimum graduating competencies in geriatrics have recently been identified for medical students. The authors describe how these competencies are being integrated into a new medical curriculum through coursework and community-based experiences.…

  13. From Malaysia to America: Community-Based Character Education for Children and Youth

    Science.gov (United States)

    Haslip, Meishi Lim; Haslip, Michael J.

    2013-01-01

    This article shares lessons learned from the implementation of a community-based character education program in Malaysia. The program at Jenjarom Learning Center is directed toward the transformation and empowerment of local children and youth through moral and character education. The stated purpose of the program has been to awaken the…

  14. From Malaysia to America: Community-Based Character Education for Children and Youth

    Science.gov (United States)

    Haslip, Meishi Lim; Haslip, Michael J.

    2013-01-01

    This article shares lessons learned from the implementation of a community-based character education program in Malaysia. The program at Jenjarom Learning Center is directed toward the transformation and empowerment of local children and youth through moral and character education. The stated purpose of the program has been to awaken the…

  15. A Survey on Dementia Training Needs among Staff at Community-Based Outpatient Clinics

    Science.gov (United States)

    Adler, Geri; Lawrence, Briana M.; Ounpraseuth, Songthip T.; Asghar-Ali, Ali Abbas

    2015-01-01

    Dementia is a major public health concern. Educating health-care providers about dementia warning signs, diagnosis, and management is paramount to fostering clinical competence and improving patient outcomes. The objective of this project was to describe and identify educational and training needs of staff at community-based outpatient clinics…

  16. The Role of Technology: Community Based Service-Learning Projects on Ethical Development

    Science.gov (United States)

    Ruso, Nazenin

    2012-01-01

    This study explores the utility of CBSL (community based service-learning) projects as a teaching method of ethics which this process supported by online communication tools in order to enhance progress of service learning and ethical development of undergraduate students and gather data during the research process. This study consists of an…

  17. Perceptions That Influence the Maintenance of Scientific Integrity in Community-Based Participatory Research

    Science.gov (United States)

    Kraemer Diaz, Anne E.; Spears Johnson, Chaya R.; Arcury, Thomas A.

    2015-01-01

    Scientific integrity is necessary for strong science; yet many variables can influence scientific integrity. In traditional research, some common threats are the pressure to publish, competition for funds, and career advancement. Community-based participatory research (CBPR) provides a different context for scientific integrity with additional and…

  18. Linking community-based and national REDD+ monitoring: a review of the potential

    NARCIS (Netherlands)

    Pratihast, A.K.; Herold, M.; Sy, de V.; Murdiyarso, D.; Skutsch, M.

    2013-01-01

    Countries participating in REDD+ schemes are required to establish a national monitoring system that keeps track of forest carbon changes over time. Community-based monitoring (CBM) can be useful for tracking locally driven forest change activities and their impacts. In this paper, we review some of

  19. Understanding Program Planning Theory and Practice in a Feminist Community-Based Organization

    Science.gov (United States)

    Bracken, Susan J.

    2011-01-01

    The purpose of this article is to discuss feminist-program-planning issues, drawing from a critical ethnographic study of a Latin American feminist community-based organization. The research findings discuss the centrality of feminist identity to understanding and analyzing day-to-day program-planning process issues within a feminist…

  20. Community-Based Education Support Programs in the San Francisco Bay Area.

    Science.gov (United States)

    Eldredge, Susan; Dornbusch, Sanford M.

    Although community-based education support organizations are second only to public schools in the number of young people they serve each year, there has been little substantive research on these organizations and the education support they provide. With funding from the Walter S. Johnson Foundation, a 10-month study of neighborhood-based…

  1. Rethinking Community-Based Indigenous Language Revitalization Using Cultural-Historical Activity Theory

    Science.gov (United States)

    Lin, Man-Chiu Amay; Yudaw, Bowtung

    2013-01-01

    This article suggests a theoretical framework for re-examining the complex relationship of language, literacy, and cultural practices, across multiple generations in the context of community-based Indigenous language revitalization. In the scholarship of Indigenous language revitalization and education, researchers have shifted from viewing…

  2. Community-Based Adaptation: A vital approach to the threat climate change poses to the poor

    Energy Technology Data Exchange (ETDEWEB)

    Huq, Saleemul; Reid, Hannah

    2007-05-15

    Helping the millions of poor people at greatest risk from climate change to adapt to its impacts is a daunting task. One new approach that deserves greater support is community-based adaptation (CBA). This briefing paper outlines the concepts behind CBA, shares some early lessons learned, and calls for greater networking, information sharing and support for CBA activities.

  3. Rethinking Community-Based Indigenous Language Revitalization Using Cultural-Historical Activity Theory

    Science.gov (United States)

    Lin, Man-Chiu Amay; Yudaw, Bowtung

    2013-01-01

    This article suggests a theoretical framework for re-examining the complex relationship of language, literacy, and cultural practices, across multiple generations in the context of community-based Indigenous language revitalization. In the scholarship of Indigenous language revitalization and education, researchers have shifted from viewing…

  4. Eating Disorders among a Community-Based Sample of Chilean Female Adolescents

    Science.gov (United States)

    Granillo, M. Teresa; Grogan-Kaylor, Andrew; Delva, Jorge; Castillo, Marcela

    2011-01-01

    The purpose of this study was to explore the prevalence and correlates of eating disorders among a community-based sample of female Chilean adolescents. Data were collected through structured interviews with 420 female adolescents residing in Santiago, Chile. Approximately 4% of the sample reported ever being diagnosed with an eating disorder.…

  5. Community-Based Book Reading Programs for Parents and Young Children in Japan

    Science.gov (United States)

    Hashimoto, Yuko

    2012-01-01

    Community-based volunteer programs to support children's book reading have existed in Japan for the past 70 years or so. Recently, because of the national emphasis on providing child-rearing support for families with young children, more programs are being offered to encourage parent-child shared book reading starting when children are very young.…

  6. Reflections on an Interdisciplinary, Community-Based, Team-Taught Adventure

    Science.gov (United States)

    Fauvel, Anne Marie; Miller, Lisa K.; Lane, Paul; Farris, John

    2010-01-01

    A new team-taught course focused on interdisciplinary teaching and integrative learning was offered at Grand Valley State University during the Summer of 2008 at a regional campus in Holland, Michigan. Faculty from Engineering and Business developed this community-based, alternative-format course to engage students in the question: "What will…

  7. Aligning Cost Assessment with Community-Based Participatory Research: The Kin Keeper (superscript SM) Intervention

    Science.gov (United States)

    Meghea, Cristian Ioan; Williams, Karen Patricia

    2015-01-01

    The few existing economic evaluations of community-based health promotion interventions were reported retrospectively at the end of the trial. We report an evaluation of the costs of the Kin Keeper(superscript SM) Cancer Prevention Intervention, a female family-focused educational intervention for underserved women applied to increase breast and…

  8. Touring responsibility: The trouble with ‘going local’ in community-based tourism in Thailand

    NARCIS (Netherlands)

    Sin, H.L.; Minca, C.

    2014-01-01

    This paper discusses the question of responsibility with reference to community-based tourism. Local communities are often presented by the tourist industry as an inherent value to recognize and protect. Tourists visiting distant places are thus frequently exhorted to ‘go local’ through having a

  9. Exploring Links between Empowerment and Community-Based Arts and Cultural Practices: Perspectives from Barcelona Practitioners

    Science.gov (United States)

    Carrasco, Ruben David Fernández; Monferrer, Moisés Carmona; Tarditi, Andrés Di Masso

    2016-01-01

    In this paper, we reflect on the development of community-based arts and cultural (CBAC) practices to promote psychosocial, group/organisational and community changes from the perspective of empowerment. We draw on findings from an initial exploratory phase of an ongoing action-research project in Spain about creative tools that empower artists…

  10. Beyond Traditional Art Education: Transformative Lifelong Learning in Community-Based Settings with Older Adults

    Science.gov (United States)

    Lawton, Pamela Harris; La Porte, Angela M.

    2013-01-01

    Quality community-based art education programs for older adults over the age of 50 should exploit the broad range of interests and cognitive abilities of participants by utilizing adult education theory, brain research, and the best practices of adult art education programs. We consider a developing paradigm on the cognitive abilities of the…

  11. Designing a Community-Based Lay Health Advisor Training Curriculum to Address Cancer Health Disparities

    Science.gov (United States)

    Gwede, Clement K.; Ashley, Atalie A.; McGinnis, Kara; Montiel-Ishino, F. Alejandro; Standifer, Maisha; Baldwin, Julie; Williams, Coni; Sneed, Kevin B.; Wathington, Deanna; Dash-Pitts, Lolita; Green, B. Lee

    2012-01-01

    Introduction Racial and ethnic minorities have disproportionately higher cancer incidence and mortality than their White counterparts. In response to this inequity in cancer prevention and care, community-based lay health advisors (LHAs) may be suited to deliver effective, culturally relevant, quality cancer education, prevention/screening, and early detection services for underserved populations. Approach and Strategies Consistent with key tenets of community-based participatory research (CBPR), this project engaged community partners to develop and implement a unique LHA training curriculum to address cancer health disparities among medically underserved communities in a tricounty area. Seven phases of curriculum development went into designing a final seven-module LHA curriculum. In keeping with principles of CBPR and community engagement, academic–community partners and LHAs themselves were involved at all phases to ensure the needs of academic and community partners were mutually addressed in development and implementation of the LHA program. Discussion and Conclusions Community-based LHA programs for outreach, education, and promotion of cancer screening and early detection, are ideal for addressing cancer health disparities in access and quality care. When community-based LHAs are appropriately recruited, trained, and located in communities, they provide unique opportunities to link, bridge, and facilitate quality cancer education, services, and research. PMID:22982709

  12. A Cervical Cancer Community-Based Participatory Research Project in a Native American Community

    Science.gov (United States)

    Christopher, Suzanne; Gidley, Allison L.; Letiecq, Bethany; Smith, Adina; McCormick, Alma Knows His Gun

    2008-01-01

    The Messengers for Health on the Apsaalooke Reservation project uses a community-based participatory research (CBPR) approach and lay health advisors (LHAs) to generate knowledge and awareness about cervical cancer prevention among community members in a culturally competent manner. Northern Plains Native Americans, of whom Apsaalooke women are a…

  13. Predictors of quality of life of people receiving intensive community-based care

    NARCIS (Netherlands)

    Emmerink, P.M.J.; Roeg, Diana

    2015-01-01

    Purpose Intensive community-based care (ICBC) is a home-treatment approach aiming to support people ‘living in the community’ with severe psychiatric and addiction problems. Although subjective quality of life (SQOL) is an increasingly important outcome measure in health care, little is known on ICB

  14. A Cervical Cancer Community-Based Participatory Research Project in a Native American Community

    Science.gov (United States)

    Christopher, Suzanne; Gidley, Allison L.; Letiecq, Bethany; Smith, Adina; McCormick, Alma Knows His Gun

    2008-01-01

    The Messengers for Health on the Apsaalooke Reservation project uses a community-based participatory research (CBPR) approach and lay health advisors (LHAs) to generate knowledge and awareness about cervical cancer prevention among community members in a culturally competent manner. Northern Plains Native Americans, of whom Apsaalooke women are a…

  15. Community-based physical activity interventions among women: a systematic review

    Science.gov (United States)

    Amiri Farahani, Leila; Asadi-Lari, Mohsen; Mohammadi, Eesa; Parvizy, Soroor; Haghdoost, Ali Akbar; Taghizadeh, Ziba

    2015-01-01

    Objective Review and assess the effectiveness of community-based physical activity interventions among women aged 18–65 years. Design Systematic review Methods To find relevant articles, the researcher selected reports published in English between 1 January 2000 and 31 March 2013. Systematic search was to find controlled-trial studies that were conducted to uncover the effect of community-based interventions to promote physical activity among women 18–65 years of age, in which physical activity was reported as one of the measured outcomes. The methodological quality assessment was performed using a critical appraisal sheet. Also, the levels of evidence were assessed for the types of interventions. Results The literature search identified nine articles. Four of the studies were randomised and the others studies had high methodological quality. There was no evidence, on the basis of effectiveness, for social cognitive theory-based interventions and inconclusive evidence of effectiveness for the rest of interventions. Conclusions There is insufficient evidence to assess the effectiveness of community-based interventions for enhancing physical activity among women. There is a need for high-quality randomised clinical trials with adequate statistical power to determine whether multicomponent and community-based intervention programmes increase physical activity among women, as well as to determine what type of interventions have a more effective and sustainable impact on women's physical activity. PMID:25833668

  16. Increasing Student Evaluation Capacity through a Collaborative Community-Based Program Evaluation Teaching Model

    Science.gov (United States)

    Carlisle, Shauna K.; Kruzich, Jean M.

    2013-01-01

    The evaluation literature reflects a long-standing interest in ways to provide practical hands-on training experience in evaluation courses. Concomitantly, some funders have shown rising expectations for increased accountability on the part of Community-Based organizations (CBOs), even though agencies often lack the associated funding and…

  17. Institutional Arrangements in seasonal floodplain management under community-based Aquaculture in Bangladesh

    NARCIS (Netherlands)

    Haque, A.B.M.M.; Visser, L.E.; Dey Madan, M.

    2011-01-01

    Seasonal floodplains under private and public ownership in the Indo-Ganges river basin provide food and income for millions of people in Bangladesh. Floodplain ownership regimes are diverse, covering the whole spectrum from public to private ownership. The paper compares community-based fish culture

  18. Home and Community Based Services (HCBS) Waivers: A Nationwide Study of the States

    Science.gov (United States)

    Rizzolo, Mary C.; Friedman, Carli; Lulinski-Norris, Amie; Braddock, David

    2013-01-01

    In fiscal year (FY) 2009, the Medicaid program funded over 75% of all publicly funded long-term supports and services (LTSS) for individuals with intellectual and developmental disabilities (IDD) in the United States (Braddock et al., 2011). The majority of spending was attributed to the Home and Community Based Services (HCBS) Waiver program. In…

  19. Public health impact of community-based nutrition and lifestyle interventions

    NARCIS (Netherlands)

    Verheijden, M.W.; Kok, F.J.

    2005-01-01

    Community-based interventions have increasingly received attention since researchers and public health professionals have come to acknowledge the importance of an environment that makes the healthy choice the easy choice. All stakeholders including the target community are involved to achieve change

  20. Local Knowledge and Adult Learning in Environmental Adult Education: Community-Based Ecotourism in Southern Thailand

    Science.gov (United States)

    Walter, Pierre

    2009-01-01

    This paper examines how local knowledge is employed in environmental adult education in a community-based ecotourism project in an island community in southern Thailand. The study is based on field research and analysis of project websites, media reports and documents. Situated at the intersection of global tourism and a local Thai-Malay Muslim…