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Description
Social determinants of health present significant barriers to utilization of maternal health services in transitional countries. This dissertation study examined associations between household autonomy and utilization of prenatal services among women of reproductive age in Armenia and Azerbaijan. Using nationally representative survey data, this study explored if household autonomy of women positively influenced the timing of the first prenatal visit, the number of prenatal care visits, and the content of care during visits. Results showed that household autonomy was positively associated with the timing of the first visit for prenatal care and the number of prenatal care visits. The content of care was negatively associated with the autonomy of women. Findings also pointed to an endogenous influence of a woman's position in the household structure. Additionally, this study analyzed associations between women's reproductive history and utilization, and economic disparities in utilization of prenatal care. The findings demonstrated that a history of complications during pregnancy and stillbirths were positively associated with utilization of prenatal care. Economic disparities in utilization of care were identified. Future interventions to increase utilization of maternal health services should account for traditional household structures in transitional countries. Women from poor families should receive support from social assistance and the health sector in accessing services pertaining to their health and well-being.
ContributorsUrbaeva, Zhyldyz (Author) / Anderson, Steven (Thesis advisor) / Krysik, Judy (Thesis advisor) / Herbst, Chris (Committee member) / Arizona State University (Publisher)
Created2015
Description
Traumatic events have deleterious effects biologically, emotionally, socially, and cognitively. Events may include violence, neglect, and abuse and are best understood through a lifecourse perspective. Preventable and treatable, traumatic exposure promotes the development of trauma symptoms including avoidance, hyperarousal, increased fear, intrusive experiences, and aggression/violence. Trauma symptomology is thought to be an underlying cause of child maltreatment and intergenerational cycles of abuse
eglect. Traumatic symptoms may interfere with the ability to work, function, and care for young children and may accompany a Post-Traumatic Stress Disorder (PTSD) diagnosis.
Although these experiences are known to be harmful, little research has focused on experiences of mothers involved in the child welfare system with young children (< 5 years). Subsequently, this study explored maternal experiences of trauma whilst calculating one of the first PTSD estimates. Types of trauma exposure, age of exposure, and event details were explored alongside history of substance use, domestic violence, and mental illness. Trauma symptom type, severity, and frequency were assessed. Utilizing adult attachment as a partial mediator, relationships between trauma exposure, trauma symptoms, and parenting were examined.
Supported by a university-community collaboration within the Safe Babies Court Teams Program in Maricopa County, Arizona, this study is exploratory and cross-sectional. A convenience sample of child welfare involved mothers (N = 141) with young children were recruited who were new clinical intakes with open court dependencies. Data on child/adult traumatic events, trauma symptoms, adult attachment, and parenting were collected. Results indicated high rates of complex/chronic trauma, specifically domestic violence and physical/sexual abuse. Mothers experienced higher than average childhood adversity/emotional abuse with significant overlap between trauma exposure and reduced mental health. PTSD rates ranged from 35-39%. Adult attachment did not to mediate trauma on parenting behaviors however strong and significant direct effects were found. Insecure-disorganized and insecure-resistant were the most dominant attachment styles.
Overall, these findings indicate the complex lifecourse nature of trauma exposure and the need to pay special attention to mental health and domestic violence histories in child welfare involved mothers of young children. Implications for social work practice, policy, and research are presented and provide impetus for continued future work.
eglect. Traumatic symptoms may interfere with the ability to work, function, and care for young children and may accompany a Post-Traumatic Stress Disorder (PTSD) diagnosis.
Although these experiences are known to be harmful, little research has focused on experiences of mothers involved in the child welfare system with young children (< 5 years). Subsequently, this study explored maternal experiences of trauma whilst calculating one of the first PTSD estimates. Types of trauma exposure, age of exposure, and event details were explored alongside history of substance use, domestic violence, and mental illness. Trauma symptom type, severity, and frequency were assessed. Utilizing adult attachment as a partial mediator, relationships between trauma exposure, trauma symptoms, and parenting were examined.
Supported by a university-community collaboration within the Safe Babies Court Teams Program in Maricopa County, Arizona, this study is exploratory and cross-sectional. A convenience sample of child welfare involved mothers (N = 141) with young children were recruited who were new clinical intakes with open court dependencies. Data on child/adult traumatic events, trauma symptoms, adult attachment, and parenting were collected. Results indicated high rates of complex/chronic trauma, specifically domestic violence and physical/sexual abuse. Mothers experienced higher than average childhood adversity/emotional abuse with significant overlap between trauma exposure and reduced mental health. PTSD rates ranged from 35-39%. Adult attachment did not to mediate trauma on parenting behaviors however strong and significant direct effects were found. Insecure-disorganized and insecure-resistant were the most dominant attachment styles.
Overall, these findings indicate the complex lifecourse nature of trauma exposure and the need to pay special attention to mental health and domestic violence histories in child welfare involved mothers of young children. Implications for social work practice, policy, and research are presented and provide impetus for continued future work.
ContributorsKawam, Elisa (Author) / Krysik, Judy (Thesis advisor) / Shafer, Michael (Committee member) / Roe-Sepowitz, Dominique (Committee member) / Arizona State University (Publisher)
Created2015