- What We Do
- Get Involved
- About Us
Maternal and neonatal mortality remain significant problems globally despite use of effective interventions such as stimulating and warming the neonate and active management of the third stage of labor. In Mexico, although most births occur in health facilities attended by physicians, there is still a significant rate of home deliveries attended by traditional birth attendants (TBA). Several studies have demonstrated interventions aimed at TBAs that improve maternal and infant outcomes; however, scaled-up implementation has been disappointing. New strategies for effectively strengthening beneficial TBA practices are sorely needed.
One method of instituting widespread training in basic obstetrical emergency management is through technology. The Engender Games Group (EGG) in collaboration with the University of Washington created Emergency Birth!, a video game aimed at improving outcomes for births occurring outside of a hospital. The game is culturally and socioeconomically neutral, and uses an interactive birth scenario to reinforce safe obstetric practice during childbirth. The study objective is to pilot test the Emergency Birth! game for acceptability, feasibility and effectiveness in rural Mexican TBAs. TBAs will be asked twice (1-3 months apart) to play the game and answer interview questions. The two sets of play scores and interview questions per participant will be used to assess changes in knowledge of game content and attitudes toward the game. Focus group interviews will be conducted to supplement the quantitative data and delve into the nuances of video game acceptability for this population, as well as identify barriers and facilitators to its effectiveness in the future iterations."
In India, domestic violence has been closely linked with depression and the subsequent development of posttraumatic stress disorder (PTSD), even among pregnant women. Perinatal mental disorders have been associated with low birth weight and premature infants, and a decreased tendency for the mother to breastfeed, subsequently reducing the child’s ability to fight off infection. Clearly, reducing psychological distress among pregnant women should be a public health priority, as these disorders affect not only the mother, but also the next generation. Yet, in India, mental health screening is not systematically implemented in antenatal clinics and other non-specialty settings, and pregnant women with anxiety and depression suffer—as do their children— undiagnosed and untreated. The World Health Organization (WHO) reports that the obstetrical service delivery sector is the primary point of health care contact for many women with mental health disturbances in low income countries. As such, this study aims to measure the prevalence of depressive and PTSD symptoms in pregnant women seeking antenatal care in a semi-rural clinic via interviews and examine the impact of these symptoms on birth outcomes via postpartum health records. Secondly, this study aims to begin to adapt a culturally appropriate intervention to be implemented within antenatal clinics to relieve psychological distress among pregnant women. We will be examining the appropriateness of interpersonal and cognitive processing therapies in the study population through interviews with women who have screened positive for a major depressive disorder or PTSD and the health care professionals who work with these women.
One of the earliest reproductive health challenges faced by young, sexually active African women is the risk of sexually transmitted infections (STIs). This problem is rarely addressed due to socio-cultural obstacles to informed discussions around sexual and reproductive health issues. Actions to address this situation are desperately needed. Chlamydia trachomatis is a common bacterial STI that is often asymptomatic. Consequently, many at-risk individuals remain untreated, resulting in severe complications such as pelvic inflammatory disease, tubal infertility, and ectopic pregnancy. In developed countries, the prevalence of infection among young women (<25 years) is high (~15%). Data among youth in sub-Saharan Africa are limited. We recently demonstrated that the incidence of C. trachomatis among younger (<25 years) women in Mombasa who reported transactional sex was 27.6/100 person-years. This startlingly high incidence among high-risk women motivated us to explore the feasibility of C. trachomatis screening in female adolescents (ages 15-17) and young women (ages 18-24) in the general population. Our multidisciplinary approach begins with in-depth interviews and focus group discussions with adolescents, young women, parents, and community members to identify barriers to C. trachomatis screening among females (15-24). Subsequently we‘ll perform a cross-sectional study using nucleic acid amplification tests of urine samples to compare the acceptability of C. trachomatis testing among female adolescents and young women. Successful completion of this study will help to determine the need for broader screening among young women in Kenya. This work will also identify and address barriers to sexual health screening in a resource-limited setting in Africa.