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Water and handwashing in a drought-prone region of southern Niger: How environment, household infrastructure, and exposure to social and behavior change messages interact
No full textThis study aims to inform multisectoral development programs by exploring the extent to which social and behavior change (SBC) messages, environment, and household infrastructure are associated with knowledge and practice of handwashing behaviors. A cross-sectional survey of 2,708 households in the Maradi and Zinder districts of Niger was collected in April 2021. Household data were integrated with two local environmental measures: 1) water level at the nearest waterhole point, and 2) anomalous rainfall for the previous rainy season derived from climate hazards infrared precipitation with station rainfall (CHIRPS) data. Logistic regression models were constructed to explore how environment, household infrastructure, and exposure to SBC messages were associated with two hygiene-related outcomes: 1) observed water and soap available at household handwashing stations, a behavior, and 2) knowledge of critical moments for handwashing, a behavioral determinant. We find that in households near a water point with higher water depth, households were statistically significantly more likely (odds ratio [OR] = 1.25); (confidence interval [CI] = 1.12–1.49) to have water and soap observed at the handwashing station. Women in households near a water point with increased water depth (more water) were more likely to know three or more critical handwashing moments (OR = 1.07; CI = 1.03–1.11). Exposure to messages about the importance of handwashing was significantly associated with knowledge of critical handwashing moments and having water and soap observed at a handwashing station. Multisectoral programming should consider layering efforts so that development projects that increase access to water sources are complemented with SBC approaches focused on hygiene
New approaches for developing biomarkers of hormonal contraceptive use
No full textTo identify biomarkers of hormonal contraceptive (HC) use in urine and saliva, we conducted a pilot study with 30 women initiating levonorgestrel (LNG) containing combined oral contraceptives (COCs) or depot medroxyprogesterone acetate (DMPA) (15/group). Based on established COC pharmacokinetics, we collected serum and urine samples before COC ingestion and during Days one and three of use, or before DMPA injection and on Days 21 and 60 post-injection. We used liquid chromatography-tandem mass spectrometry (LC–MS/MS) to measure serum/urine LNG and MPA. LNG was undetectable at baseline (specificity 100%); post ingestion, most urine samples had detectable LNG levels (sensitivity: 80% 6 h post Dose one, 93% 6 h post Dose three). We used a DetectX LNG immunoassay kit and showed 100% sensitivity measuring urine LNG. Urine MPA levels were undetectable in 14/15 women at baseline (specificity 91%); post-injection all urine samples had detectable MPA levels (sensitivity: 100% days 21 and 60). Results suggest urine sampling can be used to identify a biomarker of LNG and MPA use. Based on evidence from other steroidal hormonal studies showing changes affecting the transcriptome profile of saliva at 24 h, we used the same (COC, DMPA) timepoints to collect saliva. We performed transcriptome analysis and detected several differentially expressed genes in DMPA users’ saliva on Days 21 and 60 compared to baseline; none among COC users. We plan further research of differential gene expression in saliva as a HC biomarker of DMPA use, and will explore longer periods of COC use and saliva collection times, and application of microRNA sequencing to support using saliva as a COC biomarker
Hysterectomy and women’s health in India: Evidence from a nationally representative, cross-sectional survey of older women
No full textBackground: Hysterectomy, particularly when conducted in women younger than 45 years, has been associated with increased risk of non-communicable diseases. In India, research indicates that hysterectomy is a common procedure for women, but there have been no studies on its long-term effects. We examined patterns of hysterectomy amongst women in India and associations with their health and well-being in later life. Methods: This analysis utilised the first wave of the Longitudinal Study on Aging in India, a nationally representative study of adults that included a module on health and well-being. We analysed data on 35,083 women ≥45 years in India. We estimated prevalence of hysterectomy and performed multivariable logistic regression to identify associated risk factors and to examine the association between hysterectomy status and eight self-reported chronic conditions, hospitalisation and mobility. Results: The prevalence of hysterectomy among women \u3e=45 years was 11.4 (95% CI: 10.3, 12.6), with higher odds among urban women (aOR: 1.39; 1.17,1.64) and higher economic status (highest compared to lowest quintile: aOR: 1.95; 1.44, 2.63). Hysterectomy history was associated with four chronic conditions: hypertension (aOR: 1.51; 95% CI: 1.28, 1.79), high cholesterol (aOR: 1.43; 1.04, 1.97), diabetes (aOR: 1.69; 1.28, 2.24), and bone/joint disease (aOR: 1.54; 1.20, 1.97) and higher odds of any hospitalisation in the past year (aOR: 1.69; 1.36, 2.09). Conclusions: In India, evidence suggests that hysterectomy is associated with major chronic conditions. The assessment for hysterectomy as a treatment option for gynaecological morbidity should consider potential health consequences in later life
Provider behavior change: Social and behavior change approaches to quality of care in family planning
Get PDFBreakthrough RESEARCH was USAID’s flagship social and behavior change (SBC) research and evaluation project to drive the generation, packaging, and use of innovative SBC research to inform programming. A six-year project (2017–2023), Breakthrough RESEARCH was led by the Population Council in collaboration with our consortium partners: Tulane University, Avenir Health, Population Reference Bureau, Institute for Reproductive Health at Georgetown University, and ideas42. This legacy resource highlights evidence, insights, and learnings over the past six years from Breakthrough RESEARCH’s work to advance provider behavior change (PBC) programming and fill critical PBC evidence gaps
El impacto del cambio climático en los medios de subsistencia y en las oportunidades educativas de la juventud
No full textEl impacto del cambio climático en la salud: experiencias de la juventud de Bangladesh, Guatemala y Nigeria
No full textThe Radical Power of Education—Brief
Get PDFThis research brief summarizes the findings of GEJE’s recent report on the impact of education across society
Achieving maternal and neonatal mortality development goals effectively: A cost-benefit analysis
No full textEach year, 295,000 women die during and just after pregnancy, and 2.4 million babies die in the first month of their lives. In 2019, 2,160,000 neonatal deaths and 275,000 maternal deaths occurred in low-income and lower-middle-income countries alone, translating to a welfare loss equivalent to 36 billion for neonatal and maternal deaths, respectively. The total loss was 3.2 billion per year more investment and will deliver benefits worth 25 billion annually. For every 87. The benefit-cost ratio is 87
Trends in female genital mutilation in Kenya: Insights from further analysis of the Kenya Demographic and Health Surveys, 2003–2022
Get PDFHighlights and recommendations: From 2003 to 2022, Kenya has experienced a commendable reduction in FGM prevalence among women aged 15–49 years at the national level. However, this progress is not uniform: regional disparities exist, with counties such as Mandera, Wajir, Samburu, and Isiolo consistently posting high FGM prevalence across the years. FGM prevalence has remained stubbornly high among women with no education, women in the poorest households, women of the Islamic faith and those from the Somali ethnic group. There is a concerning trend indicating a shift to younger ages at which FGM is performed, particularly with an observed increase in performing it at the ages of 5–9 years. Findings also show a disturbing trend, with an increase in the proportion of health professionals conducting FGM (medicalisation), particularly in Nyamira and Kisii counties. The data underscores the necessity of targeted and nuanced interventions, stringent enforcement of anti-FGM laws, and increased community and health professional engagement to eliminate this harmful practice across all demographics and regions within the country
The interdependent forces of local growth: A county-level study, 2001–2011
No full textPerspectives in human ecology and political economy present local growth as a syndrome of interdependent changes happening over time within municipalities. This quantitative study examines the reciprocal relationship between three core concepts of growth: employment, land development, and migration. To assess these associations across the United States, covering the years 2001–2011, we merge county-level data (n = 3,108) from three sources: USA Counties’ Employment Data; satellite imagery from the National Land Cover Database; and the Internal Revenue Service’s County-to-County Migration Data. In structural equation models (SEMs) with cross-lagged associations, we estimate the reciprocal relationship between first-difference change scores for three variables: the unemployment rate, the area of human constructed impervious surfaces (i.e. land development), and the ratio of in/out migration. While land development and migration are in an asymmetric, positive feedback loop, the reciprocal association between unemployment and migration is positive in one direction and negative in the other. With SEM, the analysis contributes to the literature by highlighting the social forces of local growth as an interdependent system of reciprocal change, although not fully recursive