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Community-based development: scaling up the correct use of misoprostol at home births in Afghanistan
Description
Globally, more than 350 000 women die annually from complications during pregnancy and childbirth (UNFPA, 2011). Nearly 99% of these, according to World Health Organization (WHO) trends (2010) occur in the developing world outside of a hospital setting with limited resources including emergency care (WHO, 2012; UNFPA, 2011). The most prevalent cause of death is postpartum hemorrhage (PPH), accounting for 25% of deaths according to WHO statistics (2012). Conditions in Afghanistan are reflective of the scope and magnitude of the problem. In Afghanistan, maternal mortality is thought to be among the highest in the world. The Afghan Mortality Survey (AMS) data implies that one Afghan woman dies about every 2 hours from pregnancy-related causes (AMS, 2010). Lack of empowerment, education and access to health care resources increase a woman's risk of dying during pregnancy (AMS, 2010). This project aims to investigate the prospects of scaling-up the correct use of misoprostol, a prostaglandin E1 analogue, to treat PPH in developing countries where skilled assistance and resources are scant. As there has been little published on the lessons learned from programs already in place, this study is experience-driven, based on the knowledge of industry experts. This study employs a concurrent triangulation approach to synthesize quantitative data obtained from previous studies with qualitative information gathered through the testimonies of key personnel who participated in pilot programs involving misoprostol. There are many obstacles to scaling-up training initiatives in Afghanistan and other low-resource areas. The analysis concludes that the most crucial factors for scaling-up community-based programs include: more studies analyzing lessons learns from community driven approaches; stronger partnerships with community health care workers; overcoming barriers like association with abortion, misuse and product issues; and a heightened global and community awareness of the severity of PPH without treatment. These results have implications for those who actively work in Afghanistan to promote maternal health and other countries that may use Afghanistan's work as a blueprint for reducing maternal mortality through community-based approaches. Keywords: Afghanistan, community-based interventions, community-driven, maternal mortality, MDG5, misoprostol, postpartum hemorrhage, reproduction, scale-up
ContributorsCristy, Candice (Author) / Grossman, Gary (Thesis advisor) / Parmentier, Mary-Jane (Committee member) / Byrd, Denise (Committee member) / Arizona State University (Publisher)
Created2013
Description
Parents die during the lives of their children. If the child is an adolescent, that death will impact the student's education immediately or in subsequent years. Findings show the death of a mother does impact the daughter's education. It is imperative educators are willing to work with the student at the time the death occurs as well as in the ensuing months. Seidman's (2006) three-interview format was used as a template for the interviews of 11 women, ranging in age from 19 to 78 and whose mothers died when the women were adolescents. The interviews were primarily conducted in one sitting, transcribed, and then analyzed for common themes that connected to the research on the topic. Those themes include grieving, the role of caring in education, the role of teacher as the second mother, mother-daughter relationships, and the impact of parent death on schooling. These themes from the data cross cut with thematic strands within the study's theoretical framework: the nurturing and empathetic role of the mother, a desire of the daughter not to be different, and the ethics of caring. Findings in this study reveal that the negative impacts of mother loss are felt in diffuse ways, such as a lack of academic or emotional encouragement. Many women discussed the need and availability of support groups including groups at colleges. One practical implication of these findings is schools need to become caring communities in which caring is the norm for all students and teachers, thereby providing all students with needed support in times of crisis. The implications for further research include the impact of the mother death on the education of daughters, how volunteering with an organization related to the cause of the mother's death assists the daughter and types of programs most important to a student's success in post-secondary education. Adolescents are in a time of great change in their lives, and for a daughter, the loss of a mother has an everlasting, life-changing impact.
ContributorsRatti, Theresa Helen McLuskey (Author) / Mccarty, Teresa L (Thesis advisor) / Fischman, Gustavo E. (Committee member) / Powers, Jeanne M. (Committee member) / Arizona State University (Publisher)
Created2011
Description
Chronic illness can affect multiple domains of functioning, yet scientific understanding of the effects across the lifespan and under multiple contexts is still developing. For instance, research consistently indicates the early years of a child's life are pivotal for early intervening to positively affect physical, cognitive, and socio-emotional development; unfortunately, the impact of chronic illnesses, and thus appropriate interventions, during this time are not well-established. Academic achievement is one area in which children with chronic illness are negatively affected and research suggests that the effects of illness can be exacerbated by certain social determinants of health and demographic characteristics; however, no recent studies have examined these relationships for children at school entry. The current study utilized the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) to examine variations in early academic readiness in reading and mathematics by diabetes status, race, and social determinants, specifically mother's education and access to early childhood education, among children born in 2001. Results of the current study indicated that children with diabetes scored lower on reading and mathematics relative to their non-diabetic peers. Significant interactions were evident for diabetes status by mother's education, race/ethnicity, and by early childhood education. Children in homes whose mothers had the lowest level of education did not score as high as children in homes with mothers who had higher levels of education. Among children without diabetes, those identified as Asian, Pacific Islander, or Native Hawaiian outperformed White, Black, Hispanic, American Indian, and multi-race groups on measures of reading and mathematics, whereas among children with diabetes, those identified as multiracial scored highest. Regardless of diabetes status, children who attended preschool outperformed those who did not, yet children without diabetes who had not attended preschool outperformed diabetic children who did receive such services. Findings support the need for targeted early intervention as preschool alone did not mitigate the effects of diabetes on academic performance.
ContributorsKucera, Miranda (Author) / Sullivan, Amanda L (Thesis advisor) / Wodrich, David (Committee member) / Thompson, Marilyn (Committee member) / Arizona State University (Publisher)
Created2012
Description
The transition to kindergarten is a significant milestone for children and families in the United States. Education reform movements and early childhood policy initiatives have had significant impact on the transition process in recent years, and as a result, there is greater emphasis on promoting "ready children" for school. Previous research on the transition to kindergarten in the U.S. consists primarily of adult perspectives, examining parents and teachers' expectations for kindergarten and explicating their concerns about the transition. While adults impart important considerations about the transition to kindergarten, members of the early childhood community should also pay attention to children's perspectives as they too offer critical insight on getting ready for school. This dissertation foregrounds children's and experiences getting ready for and being in kindergarten, bringing attention their participation in transition activities and school routines. In addition, this study examines ways parents structure children's participation in transition activities and school routines to provide background information on children's experiences preparing for school. This study used data from a large-scale qualitative research project conducted in Arizona to understand children's experiences transitioning to kindergarten. Specifically, interviews with preschool-aged children, kindergarten-aged children, and mothers were analyzed to impart a deeper understanding of children's viewpoints becoming and being kindergarteners. Findings illustrate how mothers' understandings of kindergarten, and constructions of readiness have influence over the transition process. Moreover, findings offer thick descriptions of how children learn about kindergarten, make meaning of school rules and routines, and form membership within classroom communities of practice. Moreover, interpretations of children's viewpoints contribute nuanced understandings of situations that promote or hinder children's participation in transition activities, and subsequent engagement in kindergarten classrooms. This study contributes to the ongoing discourse on kindergarten readiness. The viewpoints of children and parents on getting ready for and being in kindergarten provide alternative perspectives, contributing to a more holistic understanding of the transition experience. Further, a key implication of this study is that children's perspectives be given due weight in practical, programmatic, and policy initiatives aimed at promoting positive and successful transitions to kindergarten.
ContributorsPeters, Lacey (Author) / Swadener, Beth Blue (Thesis advisor) / Tobin, Joseph (Committee member) / Nakagawa, Kathryn (Committee member) / Weigand, Roberto (Committee member) / Arizona State University (Publisher)
Created2012
Description
The largest scholarship program of its kind worldwide, the King Abdullah Scholarship Program, which began in 2005, allowed any Saudi Arabian citizen admitted into an approved higher education institution worldwide to receive a full scholarship, allowing more than 200,000 students to study abroad. A large portion of the Saudi scholarship students commonly study abroad with their families; either they have young children or are newly married and have children while they are in the United States. Since these children are primarily exposed to English environments in their communities, daycare centers and schools during their time in the United States, they often face challenges to learn Arabic other than at home with their parents. This dynamic can pose many challenges for the children and their families when returning to and adapting back to life in Saudi Arabia, linguistically, educationally and culturally. This research aims at: 1) investigating the language context of the Saudi mothers and children abroad, 2) understanding Saudi mothers' attitudes towards their children’s bilingualism in the United States and, 3) highlighting Saudi mothers’ roles in supporting language skill and the development of their children while living outside of Saudi Arabia. To achieve this, data was collected using three qualitative methods: interviews and brief surveys with Saudi mothers, and observation of their children in their playrooms. The findings suggest that educators in Saudi Arabia should be aware that those returning may sometimes need assistance to be able to fit linguistically in the community.
ContributorsAlzubaidi, Noor (Author) / Adams, Karen (Thesis advisor) / Prior, Matthew T. (Thesis advisor) / James, Mark (Committee member) / Arizona State University (Publisher)
Created2018
Description
The field of developmental psychology often underrepresents Latinx individuals within their corpus of published scholarship. In the area of lifespan identity development this is particularly evident from the scarcity of Latinx life story narratives. In addition, Latinx family parenting styles is an underdeveloped area of scholarship. At the same time, a robust literature base demonstrates that for youth from non-dominant culture families, ethnic racial identity increases measures of adaptive well-being and academic achievement. Because academic achievement for Latinx students does not proportionately reach levels of educational success as compared to whites, research investigating foundations of ethnic racial identity within Latinx families is warranted. This investigation extends parenting style literature within the field of developmental psychology by exploring inter-generational practices of Latinx families. Participants within this study include mothers of Mexican descent who have earned at least one Master's degree, a level of high academic achievement attained by only 10 percent of adults within the U.S. Each Latina mother, ranging in age from 36 to 63 years, participated in two or more semi-structured interviews. Protocols were based on McAdams's life story interview; McAdams's life story narrative analysis, based upon Erikson's lifespan theory of identity development, provided a model of analysis. In addition, transcripts of participant interviews, totaling more than twelve hours, were analyzed according to themes of parenting styles and family socialization practices. Familial ethnic socialization was embedded within routines and practices of mothers' families of orientation. Mothers employed a concerted cultivation parenting style within their families of procreation. In alignment with McAdams's framework, mothers narrated life stories in a redemptive manner. In other words, a negative life event was conveyed as having a positive outcome. Implications from my study inform scholars and can offer usable information for parent and teacher education by means of contextualized family activities and parental practices gleaned from participants' life story narratives.
ContributorsMulligan, Anne (Author) / Nakagawa, Kathryn (Thesis advisor) / Swadener, Elizabeth Blue (Committee member) / Moore, Elsie (Committee member) / Arzubiaga, Angela (Committee member) / Arizona State University (Publisher)
Created2018
DescriptionA short film about a mother and a daughter.
ContributorsJun, Seo-Young (Author) / Taylor, Philip (Thesis director) / Bernstein, Gregory (Committee member) / Clay, Anne Safiya (Committee member) / Barrett, The Honors College (Contributor) / School of Film, Dance and Theatre (Contributor)
Created2013-12
Description
Childbirth, an essential stage of human life, has been carried out and treated differently in numerous ways throughout time. Although the overall method of birth is biologically the same, women and medical professionals in the United States in particular have changed how they view and manage childbirth over the past 70 years. Some of said changes are extensive and occurred more rapidly than one might typically expect for such a delicate and important stage of a woman‘s, and infant‘s, life. As consumerism, capitalism, and the courts have changed America‘s lifestyles, politics, and society, so too have they drastically affected the way we are conditioned to approach childbirth. More importantly, as society changes over time, the medical field and
methods of specialists also change, and although the benefits of these changes are challenged by some individuals, these procedures and recommendations from professionals inevitably affect us all. Methods and procedures of modern, medicalized childbirth, and even the significance placed on the event, are products of historical and cultural factors influenced by scientific and social trends. However, there exists a small and steadily growing number of women and families who choose to have their birth take place outside of the present societal norm, and consequently outside of hospitals. This group‘s existence and growth has been attributed to several factors, including changes in societal values, differentiation between different financial classes, and the
medicalization of childbirth. Although statistically a small percentage of the majority, these women who choose to give birth outside of a hospital exist amidst an immense ongoing controversy between gynecologists, physicians, mothers, and midwives regarding what options should be available when childbirth is undertaken in the United States.
methods of specialists also change, and although the benefits of these changes are challenged by some individuals, these procedures and recommendations from professionals inevitably affect us all. Methods and procedures of modern, medicalized childbirth, and even the significance placed on the event, are products of historical and cultural factors influenced by scientific and social trends. However, there exists a small and steadily growing number of women and families who choose to have their birth take place outside of the present societal norm, and consequently outside of hospitals. This group‘s existence and growth has been attributed to several factors, including changes in societal values, differentiation between different financial classes, and the
medicalization of childbirth. Although statistically a small percentage of the majority, these women who choose to give birth outside of a hospital exist amidst an immense ongoing controversy between gynecologists, physicians, mothers, and midwives regarding what options should be available when childbirth is undertaken in the United States.
ContributorsHernandez, Dustin (Author) / Nguyen, Christy (Author) / Koblitz, Ann (Thesis director) / Budolfson, Arthur (Committee member) / Walker, Shell (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor) / W. P. Carey School of Business (Contributor)
Created2012-12
Description
Intake of alcohol, tobacco, and illicit substances such as marijuana and methamphetamine during pregnancy can have significant deleterious effects on a developing fetus and the resulting infant. The existence of substance-exposed newborns also has negative impacts on society as a whole; these include financial burdens placed on taxpayers and the additional time and resources required by health care professionals, social workers, and law enforcement authorities to properly care for such infants. Existing literature show a strong correlation between prenatal care and improved birth outcomes, including abstinence from or reduction of prenatal substance abuse. The Health Start Program in the state of Arizona attempts to mitigate the incidence of substance-exposed newborns, among other goals, by employing community health workers who identify high-risk pregnant and postpartum women, inform these women about how to receive prenatal care services, educate them on appropriate prenatal and neonatal care, and provide program and referral services to both pregnant and postpartum women. Community health workers interact directly with women most at-risk for prenatal substance abuse and should be well-versed in the understanding of the complex issues related to substance-exposed newborns. In an attempt to discover, analyze, and compile those complex issues with which community health workers should be knowledgeable, this project explores existing federal regulations regarding substance-exposed newborns, compares Arizona’s regulations to Minnesota’s, Virginia’s, and Washington’s, and analyzes prevailing literature in the field about the various implications associated with screening and reporting substance-exposed newborns to law enforcement authorities. After an intensive literature review, this project concludes that the Health Start Program needs a comprehensive resource document which enumerates federal and select state policies, landmark cases involving substance-abusing pregnant women and the precedence set by each, and recommendations from medical and public health experts. The document should also provide clear guidelines by which each stakeholder should abide and why, and recommend potential best practices the state of Arizona could adopt into law based on other state policies which have proven to be effective.
ContributorsTantibanchachai, Chanapa (Author) / Maienschein, Jane (Thesis advisor) / Ellison, Karin (Thesis advisor) / Coursen, Cristi (Committee member) / Arizona State University (Publisher)
Created2015
Description
Strong Mothers Strong Teeth is an initiative to educate mothers and pregnant women about the importance of maintaining their own and their child(ren)’s oral health. This project presents evidence that shows a lack of oral health education among mothers about how to care for their oral health while pregnant and their child’s oral health post birth. The recognition and identification of these disparities led to the content deemed necessary to be included in the education of mothers and pregnant women. By collecting and analyzing pamphlets and information gathered from health clinics and homeless shelters in Arizona and California, we created our own pamphlets based on analysis of the effectiveness of the information using content analysis and Flesch-Kincaid readability scores. This led to the creation of two pamphlets to educate mothers on oral health care, the first focused on preventing tooth decay in women during their pregnancy and for their baby, post-birth, and the second provided a timeline guide on oral health for the mother and child.
ContributorsBlair, Grace (Co-author) / Patel, Toral (Co-author) / Loebenberg, Abby (Thesis director) / Magee, Mitch (Committee member) / School of Social Transformation (Contributor) / School of Molecular Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-12