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Investments in children's health and schooling in rural southern Mozambique: the role of mothers' decision-making autonomy and father's labor migration

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The objective of this dissertation is to investigate the association of mother's autonomy and male labor migration with child's health and education, taking into account possible differences by child's gender. The dissertation uses data from a household longitudinal survey conducted in rural southern Mozambique in 2006, 2009 and 2011 to…

The objective of this dissertation is to investigate the association of mother's autonomy and male labor migration with child's health and education, taking into account possible differences by child's gender. The dissertation uses data from a household longitudinal survey conducted in rural southern Mozambique in 2006, 2009 and 2011 to address three main questions: 1) Is decision-making autonomy associated with child's schooling and child mortality? 2) Is father's labor migration associated with children's health outcomes? 3) If so, do these relationships change by gender of the child? The dissertation makes three main contributions to the literature. First, it finds a significant effect of mother's decision-making autonomy on child's outcomes, independent of other characteristics related to women's status. Second, it illustrates the cumulative nature of the effect of father's labor migration on the health of children left behind. And finally, the dissertation shows that women's decision-making autonomy and male migration affect children's outcomes differently depending on the gender of the child and on the outcome being analyzed. The dissertation is structured in five chapters. The first chapter gives an introductory overview of women's autonomy and male migration as determinants of children's outcomes, and presents the setting. The second chapter examines the relationship between mother's decision-making autonomy and enrollment for primary school-age children. Results show a positive association of women's decision-making autonomy with the probability of being enrolled for daughters, but not for sons. The effect of women's decision-making autonomy is net of other characteristics associated with autonomy. The third chapter analyzes the association of mother's decision-making autonomy and under-five child mortality. Results show a positive effect women's decision-making autonomy for sons' survival chances. The fourth chapter examines the effect of father's labor migration on health of children left behind. Results indicate that a proportion of child's life spent away by the father has a negative effect on the child's chances of being stunted but that it also decreases the likelihood of the child receiving age-adequate immunization. These results are gendered as the effect of father's migration on both outcomes is significant only for daughters. Chapter five presents the concluding remarks.
ContributorsSoares Luz, Luciana (Author) / Agadjanian, Victor (Thesis advisor) / Hayford, Sarah (Committee member) / Yabiku, Scott (Committee member) / Arizona State University (Publisher)
Created2014
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Arizona Nurses Association Member Involvement in Public Policy

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The purpose of the study was to determine the level and type of public policy involvement among registered nurses (RN) who are members of the Arizona Nurses Association (AzNA). Furthermore, the aim of the study was to identify the knowledge base and motivation of nurses and their involvement in public…

The purpose of the study was to determine the level and type of public policy involvement among registered nurses (RN) who are members of the Arizona Nurses Association (AzNA). Furthermore, the aim of the study was to identify the knowledge base and motivation of nurses and their involvement in public policy as well as the barriers and benefits. A 20- item survey was sent to all of the members of AzNA. There were 39 responses used in the analysis. The highest reported public policy activities in which the nurses had participated were: voted (90%), contacted a public official (51%), and gave money to a campaign or for a public policy concern (46%). Lack of time was the most frequently reported barrier to involvement and improving the health of the public was the most frequently reported benefit to involvement. The number of public policy education/information sources and the highest level of education positively correlate to the nurses' total number of public policy activities (r = .627 p <0.05; r = .504, p <0.05). Based on the results of stepwise linear regression analysis, the participants' age, number of education/information sources, and efficacy expectation predict 68.8% of involvement in public policy activities. The greater the number of education/information sources, the greater the number of public policy activities nurses report having participated in.
ContributorsHartman, Mykaila Corrine (Author) / Stevens, Carol (Thesis director) / Munoz, Aliria (Committee member) / Link, Denise (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2015-12
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A Gap Analysis of Syphilis Screening During Pregnancy by Prenatal Care Clinicians

Description
Congenital syphilis (CS) is increasing at an alarming rate in Arizona. The state health department has recommended increased screening to include the third trimester, but providers in individual counties are not following the recommendation. A literature search and appraisal showed increased screening reduces the incidence of CS and presented interventions…

Congenital syphilis (CS) is increasing at an alarming rate in Arizona. The state health department has recommended increased screening to include the third trimester, but providers in individual counties are not following the recommendation. A literature search and appraisal showed increased screening reduces the incidence of CS and presented interventions to increase screening rates. Furthermore, the literature suggests provider education increases screening rates. However, before education could be completed an understanding of providers current knowledge, attitudes, and practice was needed. Using this information, a gap analysis that was completed in an Arizona county (“the County”) of syphilis screening during pregnancy by prenatal care clinicians will be presented guided by the Knowledge-Attitude-Practice (KAP) Model and the ACE Star Model of Knowledge Transformation.
ContributorsWard, Kinley (Author) / Link, Denise (Thesis advisor)
Created2020-04-24
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Increasing Perimenopausal Patient and Clinician Satisfaction with Care Through Use of Shared Decision Making

Description

Vasomotor symptoms (VMS) associated with menopause vary greatly, as do the multitude of available treatment options. It can be difficult for clinicians to manage these symptoms while balancing patient safety concerns and preferences. Shared decision-making (SDM) can assist both the provider and patient to navigate the various treatment options, minimizing…

Vasomotor symptoms (VMS) associated with menopause vary greatly, as do the multitude of available treatment options. It can be difficult for clinicians to manage these symptoms while balancing patient safety concerns and preferences. Shared decision-making (SDM) can assist both the provider and patient to navigate the various treatment options, minimizing gaps between their preferences.

To assess the effect of SDM in a nurse-led practice in the Southwest, two nurse practitioners (NP) were invited to use a menopausal decision aid (DA). Women aged 40 to 64 years experiencing VMS were invited to participate in the project. Following a visit with the NP in which the DA was used, patients completed a six question post-intervention survey based on both the Decisional Conflict Scale (DCS) and SDM-Q-9 surveys. Patients were also asked to complete a telephone interview about the process 1-2 weeks post-intervention. The NP completed a post-intervention survey based on the SDM-Q-Doc to assess clinician satisfaction with the SDM process. Eight patients (mean age, 47.9 years), presenting with a range of 2 to 6 perimenopausal symptoms participated in the project.

All patients (100%) strongly or completely agreed that the clinician precisely explained the advantages & disadvantages of treatment options, helped them understand all the information, reached an agreement on how to proceed with care, and were extremely satisfied or satisfied with their decision and making an informed choice. Both clinicians completely agreed they had come to an agreement on how to proceed, and completely or strongly agreed they helped the patient understand all information. There was a correlation between the use of SDM patient’s age, making an informed choice, and being satisfied with their decision. Incorporating a perimenopausal DA can enhance patient and clinician satisfaction with SDM to understand their treatment options and make an informed menopausal decision.
ContributorsPuttbrese, AnnMarie (Author) / Link, Denise (Thesis advisor)
Created2017-05-03