A5037143256- Global Maternal and Child Health
- Adolescent Sexual and Reproductive Health
- Healthcare Systems and Reforms
- Maternal and Perinatal Health Interventions
- Poverty, Education, and Child Welfare
- Global Health Care Issues
- Reproductive Health and Contraception
- Child Nutrition and Water Access
- Intimate Partner and Family Violence
- HIV/AIDS Research and Interventions
- Maternal and Neonatal Healthcare
- Healthcare Policy and Management
- Sex work and related issues
- Global Health Workforce Issues
- Child and Adolescent Health
- HIV/AIDS Impact and Responses
- Sexual Assault and Victimization Studies
- Intergenerational Family Dynamics and Caregiving
- Disaster Management and Resilience
- Gender, Labor, and Family Dynamics
- Maternal and fetal healthcare
Georgetown University
2023
London School of Hygiene & Tropical Medicine
2016-2021
University of London
2017-2019
National HIV/AIDS/STI/TB Council
2016-2018
Population Council
2015-2016
Ministry of Community Development, Mother and Child Health
2016
Management Sciences for Health
2016
University of California, Los Angeles
2016
Population Council
2015
PurposeDespite efforts to expand contraceptive access for young people, few studies have considered where women (age 15–24) in low- and middle-income countries obtain modern contraceptives how the capacity content of care sources used compares with older users.MethodsWe examined first source respondents' current method using most recent Demographic Health Survey since 2000 33 sub-Saharan African countries. We classified providers according sector (public/private) provide a range short-...
Uganda halved its maternal mortality to 343/100,000 live births between 1990 and 2015, but did not meet the Millennium Development Goal 5. Skilled, timely good quality antenatal (ANC) delivery care can prevent majority of maternal/newborn deaths stillbirths. We examine coverage, equity, sector provision content ANC 1991 2011. conducted a repeated cross-sectional study using four Demographic Health Surveys (1995, 2000, 2006 2011).Using most recent birth adjusting for survey sampling, we...
Despite efforts to make contraceptive services more "youth friendly," unmet need for contraception among young women in sub-Saharan Africa remains high. For health systems effectively respond the reproductive needs of a growing youth population, it is imperative understand their and service seeking practices. This paper describes changes over time need, use, sources care four East African countries. We used three rounds DHS data from Kenya, Rwanda, Tanzania, Uganda examine trends 1999 2015...
Objectives In Zambia, despite a relatively liberal legal framework, there remains substantial burden of unsafe abortion. Many women do not use skilled providers in well-equipped setting, even where these are available. The aim this study was to describe women's knowledge the law relating abortion and attitudes towards Zambia. Setting Community-based survey Central, Copperbelt Lusaka provinces. Participants 1484 reproductive age (15–44 years). Primary secondary outcome measures Correct...
Introduction Globally, the majority of births happen in urban areas. Ensuring that women and their newborns benefit from a complete package high-quality care during pregnancy, childbirth postnatal period present specific challenges large cities. We examine health service utilisation content along maternal continuum (CoC) 22 African Methods analysed data most recent Demographic Health Survey (DHS) since 2013 any country with at least one city ≥ 1 million inhabitants 2015. Women live survey...
Abstract Background Persistent inequalities in coverage of maternal health services sub-Saharan Africa (SSA), a region home to two-thirds global deaths 2017, poses challenge for countries achieve the Sustainable Development Goal (SDG) targets. This study assesses wealth-based continuum care 16 SSA with objective informing targeted policies ensure equity region. Methods We conducted secondary analysis Demographic and Health Survey (DHS) data from (Angola, Benin, Burundi, Cameroon, Ethiopia,...
This study explores the relationship between two health financing initiatives on women's progression through maternal continuum in Kenya: a subsidized reproductive voucher programme (2006–16) and introduction of free maternity services all government facilities (2013). Using cross-sectional survey data, we ran three multivariable logistic regression models examining effects programme, policy, insurance other determinants (1) early antenatal care (ANC) initiation (first visit within first...
Rising facility births in sub-Saharan Africa (SSA) mask inequalities higher-level emergency care-typically hospitals. Limited research has addressed hospital use women at risk of or with complications, such as high parity, linked to poverty and rurality, for whom care is essential. We aimed address this gap, by comparatively assessing rural SSA wealth parity.
A high burden of HIV in many sub-Saharan African countries has triggered renewed interest volunteer-based community health programmes as a way to support treatment roll-out and deliver services children orphaned due HIV. This study was undertaken an evaluation USAID project implemented by consortium 7 NGOs operating 52 Zambian districts. We aimed examine motivations for becoming volunteer caregivers, experiences service commitment continue volunteering the future. mixed-method survey...
Out-of-pocket (OOP) payment for modern contraception is an understudied component of healthcare financing in countries like Kenya, where wealth gradients met need have prompted efforts to expand access free contraception. This study aims examine whether, among public sector providers, the poor are more likely receive and compare how OOP injectables implants-two popular methods-differs by public/private provider type user's sociodemographic characteristics.Secondary analyses nationally...
Infectious diseases remain a significant public health challenge in low- and middle-income countries (LMICs), with HIV, tuberculosis (TB), malaria contributing significantly to morbidity mortality. Community Health Workers (CHWs) play pivotal role addressing these diseases, yet evidence on the costs cost-effectiveness of CHW-led interventions remains fragmented. We performed scoping review, searching ten databases grey literature for original studies published between August 2015 July 2024....
From 2006 to 2016, the Government of Kenya implemented a reproductive health voucher programme in select counties, providing poor women subsidised access public and private sector care. In June 2013, government introduced policy calling for free maternity services be provided all facilities. The concurrent implementation these interventions presents an opportunity provide new insights into how users adapt changing financing service provision landscape.
Zambia is one of the few countries in Africa to permit termination pregnancy (TOP) on a wide range grounds. However, substantial barriers remain TOP and postabortion care (PAC).We conducted census 153 facilities between March May 2016. We defined according whether they met basic and/or comprehensive signal functions criteria for PAC. linked our facility data estimate geographic accessibility under different policy scenarios.Overall, 16% reported had performed 39% PAC last year. Facilities...
Abstract Background In 2004, The Kenyan government removed user fees in public dispensaries and health centers replaced them with registration charges of 10 20 shillings (2004 $US 0.13 $0.25), respectively. This was termed the 10/20 policy. We examined effect this policy on coverage, timing, source, content antenatal care (ANC), equity these outcomes. Methods Data from 2003, 2008/9 2014 Kenya Demographic Health Surveys were pooled to investigate women’s ANC care-seeking. conducted an...
Although abortion is legal in Zambia under a variety of broad conditions, unsafe remains common. The purpose this project was to compare the financial costs for women when they have an induced at facility, with outside followed by care abortion-related complications. We gathered household wealth data one point time (T1) and longitudinal qualitative two points (T1 T2, three-four months later), Lusaka Kafue districts, between 2014 2015. were collected from (n = 38) obtaining termination...
Kenya is developing strategies to finance health care through prepayment achieve universal coverage (UHC). Plans transfer free maternity services (FMS) from the Ministry of Health National Insurance Fund (NHIF) are a step towards UHC. We examined views workers and women regarding transition FMS NHIF inform process.In-depth interviews among 14 facility-level managers providers, 11 county-level managers, 21 focus group discussions with who gave birth before after introduction FMS. Data were...
In the sub-Saharan Africa region, adolescent birth rate is highest in world, estimated at 100.5 births per 1000 women aged 15 to 19 years, and 2.4 times greater than global average. This analysis examines coverage levels gaps basic maternal health care for mothers living this region.We used data from national Demographic Health Surveys (DHS) Multiple Indicator Cluster (MICS) conducted between 2010 2016 22 of African Countdown 2030 priority countries with rates above 100 2016. We analyzed 11...
Abstract Background The provision of quality obstetric care in health facilities is central to reducing maternal mortality, but simply increasing childbirth not enough, with evidence that many sub-Saharan Africa do fulfil even basic requirements for safe care. There ongoing debate on whether recommend a policy birth hospitals, where staffing and capacity may be better, over lower level facilities, which are closer women’s homes more accessible. Little known about the Liberia, facility births...
Several tools have been developed to collect information on health facility preparedness provide sexual violence response services; however, little guidance exists how this can be used better understand which functions a perform. Our study therefore aims propose set of signal that framework for monitoring the availability clinical services. To illustrate potential insights gained from using our proposed functions, we analyse data census conducted in Central Province, Zambia. We collected...