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Collective action among non-governmental organizations working in maternal and child health in Haiti
Description
This mixed-methods research study examined the level of collective action that is occurring among non-governmental organizations (NGOs) working in maternal and child health in Haiti. This study takes the view that health, and by extension, maternal and child health, is a global public good; global public goods are most efficiently provided by the means of collective action. Therefore, to the extent that maternal and child health services are provided efficiently in Haiti, collective action should be occurring.
This study utilized a semi-structured interview approach to gather both qualitative and quantitative data. A total of 17 participants who were managers or executives of NGOs working in maternal and child health in Haiti were interviewed. The interviews also gathered quantitative data that characterized types of cooperation that were occurring among NGOs. The qualitative data that were collected in these interviews were analyzed using thematic analysis, and quantitative data were analyzed using social network analysis. The findings concluded that while there is cooperation occurring among NGOs in Haiti, the cooperation levels are low, networks are not very dense and there is overall general consensus that more cooperation is needed
This study utilized a semi-structured interview approach to gather both qualitative and quantitative data. A total of 17 participants who were managers or executives of NGOs working in maternal and child health in Haiti were interviewed. The interviews also gathered quantitative data that characterized types of cooperation that were occurring among NGOs. The qualitative data that were collected in these interviews were analyzed using thematic analysis, and quantitative data were analyzed using social network analysis. The findings concluded that while there is cooperation occurring among NGOs in Haiti, the cooperation levels are low, networks are not very dense and there is overall general consensus that more cooperation is needed
ContributorsMcCool, Sarah (Author) / Gaughan, Monica (Thesis advisor) / Wutich, Amber (Committee member) / York, Abigail (Committee member) / Arizona State University (Publisher)
Created2017
Description
Sexual assault at colleges and universities in the United States is a significant health and human rights issue that impacts somewhere between one-in-four and one-in-five students. Despite the alarmingly high burden, overall rates of disclosing to crisis, health, and victim services, and reporting to schools and law enforcement remain low. In order to buffer students from associated short- and long-term harm, and help them reestablish safety and pursue justice, empirically-supported, innovative, and trauma-informed secondary prevention strategies are needed. To address this pressing issue, the current study used a trauma-informed, feminist community research approach to develop and design a prototype of an internet-based decision aid specifically tailored to assist students at Arizona State University who experience sexual assault with making informed choices about reporting and seeking care, advocacy, and support on and off campus. Results from preliminary alpha testing of the tool showed that: 1. It is feasible to adapt decision aids for use with the target population, and 2. While aspects of the tool can be improved during the next phases of redrafting and redesign, members of the target population find it to be acceptable, comprehensible, and usable.
ContributorsVillegas-Gold, Michelle (Author) / Hurtado, Ana Magdalena (Thesis advisor) / Gaughan, Monica (Thesis advisor) / Durfee, Alesha (Committee member) / Arizona State University (Publisher)
Created2018
Description
Under-representation of women doctors in medical work force despite their overwhelming majority in medical schools is an intriguing social issue for Pakistan raising important questions related to evolving gender relations in Pakistani society. Previous research on the broader issue of under-representation of women in science has focused primarily on the structural barriers to women’s advancement. It does not account for the underlying subtle (and changing) gendered power relations that permeate everyday life and which can constrain (or enable) the choices of women. It also does not address how women are not simply constructed as subjects within intersecting power relations, but actively construct meaning in relation to them. It raises interesting questions about the cultural shaping of subjectivities, identities and agency of women within the web of power relations in a society such as Pakistan.
To analyze the underlying dynamics of this issue, this dissertation empirically examines the individual, institutional and social factors which enable or affect the career choices of Pakistani women doctors. Based on the ethnographic data obtained from in-depth, person centered, open ended interviews with sixty women doctors and their families, as well as policy makers and the stake holders in medical education and health administration in Lahore, Pakistan this dissertation seeks to address the complex issues of empowerment and agency in the context of Pakistani women, both in individual and collective sense.
Participation in medical education is ostensibly an empowering act, but dissecting the social relations in which this decision takes place reveals that becoming a doctor actually enmeshes women further in the disciplinary relations within their families and society. Similarly, the medical workplaces of Pakistan are marked by entrenched gendered hierarchies constraining women’s access to resources and their progression through medical career. Finally, the political implications of defining work in medicine, and devaluing care in capitalist economies is explored.
To analyze the underlying dynamics of this issue, this dissertation empirically examines the individual, institutional and social factors which enable or affect the career choices of Pakistani women doctors. Based on the ethnographic data obtained from in-depth, person centered, open ended interviews with sixty women doctors and their families, as well as policy makers and the stake holders in medical education and health administration in Lahore, Pakistan this dissertation seeks to address the complex issues of empowerment and agency in the context of Pakistani women, both in individual and collective sense.
Participation in medical education is ostensibly an empowering act, but dissecting the social relations in which this decision takes place reveals that becoming a doctor actually enmeshes women further in the disciplinary relations within their families and society. Similarly, the medical workplaces of Pakistan are marked by entrenched gendered hierarchies constraining women’s access to resources and their progression through medical career. Finally, the political implications of defining work in medicine, and devaluing care in capitalist economies is explored.
ContributorsMasood, Ayesha (Author) / Tsuda, Takeyuki (Thesis advisor) / Wutich, Amber (Committee member) / Gaughan, Monica (Committee member) / Arizona State University (Publisher)
Created2017
Description
According to traditional Chinese medicine, the month following childbirth is an important period marked by an imbalance of two opposing forces that together make up one’s health and wellbeing. A set of specialized practices called zuoyuezi (sitting the month) aid both the woman’s recovery and restoration of the balance, and require the help of someone else, usually the woman’s mother or mother-in-law. While studies conducted on the practice’s psychosocial and physical benefits have produced varied results, zuoyuezi continues to persist in Hong Kong, China, and Taiwan. Since the late twentieth century, professional zuoyuezi centers have become very popular as a commercial health care business. While the month experiences of Taiwanese and Chinese women have been widely studied, there is little research on physicians’ opinions regarding the practice, especially in Western medical settings. Taiwanese physicians, who have been trained in the Western medical tradition, present interesting case studies as both experts in Western medicine and citizens in traditional Taiwanese society. The purpose of this project is to observe how Taiwanese physicians negotiate primarily cultural practices with their professional training, and whether there is a conflict between physicians’ beliefs about zuoyuezi and physicians’ personal experiences with the practice. Twenty-seven semi-structured interviews of Taiwanese physicians were conducted at two sites in Taiwan regarding their perspective and understanding of zuoyuezi and their personal experiences with it. Following qualitative analysis, the findings showed that physicians used their Western medical training to explain the traditional worldview that holds zuoyuezi. Secondly, physicians acknowledged the benefits of zuoyuezi and the influence of culture as two primary factors in its continued existence. Finally, physicians incorporated zuoyuezi into their personal lives while modifying the traditional practices. Overall, Taiwanese physicians did not appear to have direct conflict with the cultural practice, zuoyuezi, using their medical expertise to rationalize its existence while becoming active participants and co-creators in the practice.
ContributorsChou, Cecilia (Author) / Maienschein, Jane (Thesis advisor) / Gaughan, Monica (Committee member) / Ellison, Karin (Committee member) / Arizona State University (Publisher)
Created2017
Description
Abortion is a controversial topic internationally. Most current debates about abortion concern when, if at all, it should be legal. However, researchers have shown many times that after an abortion ban, maternal and infant mortalities rise significantly, as women who seek out abortions do so regardless of abortion legality. So, is it possible to reduce abortions in a population without delegalizing abortion and, if so, how? Why do some countries have higher abortion rates than others in the presence of the same law?This dissertation answers both questions. First, I present historical evidence in the first comprehensive comparative analysis of all 15 post-Soviet countries, which have very similar abortion laws originating from the Union of Soviet Socialist Republics (USSR). Second, I use those findings to build the first agent-based model (ABM) of unintended pregnancies in a hypothetical artificial population.
USSR was the only country in the world to complete its demographic transition through abortion instead of modern contraception, and the Soviet government passed the first law in the world to allow abortion upon request in 1920. After the USSR dissolution in 1991, post-Soviet countries maintained very similar abortion laws, but had very different abortion rates for most years. Analysis of fertility data from post-Soviet countries shows that the prevalence of some specific contraceptive methods, namely the rhythm method (r = 0.82), oral pill (r = 0.56), and male condom (r = 0.51) are most strongly correlated with high abortion rates, and that sex education is a factor that reduces the rates in otherwise similar countries (p = 0.02).
The ABM shows that even basic sex education results in fewer abortions than no sex education or abstinence-based sex education (p < 0.01). In scenarios without sex education, basic quality of post-abortion contraceptive counseling (PACC) is better than no PACC or low-quality PACC at reducing abortions (p < 0.01). Still, the higher the quality of sex education or PACC, the fewer abortions in the artificial population. The ABM is adaptive and policy makers can use it as a decision-support tool to make evidence-based policy decisions regarding abortion, and, potentially, other sociobiological phenomena with some adjustments to the code.
ContributorsZiganshina Lienhard, Dina A. (Author) / Maienschein, Jane (Thesis advisor) / Gaughan, Monica (Thesis advisor) / Laubichler, Manfred (Committee member) / Ellison, Karin (Committee member) / Arizona State University (Publisher)
Created2023
Description
This dissertation explores how Sub-Saharan African women now resettled in the United States learn about sex. Prior to the colonization of Sub-Saharan Africa, extended family members such as paternal aunts and grandmothers were responsible for sexuality education for both men and women. Sexuality education often began at puberty and continued across the life span. This sexuality education covered menstruation, pregnancy, childbirth, child spacing and sexual pleasure. However, during colonization sexuality education was moved out of the hands of family members and community members and was now offered in schools. This school-based sexuality education was further disrupted by migration from Sub-Saharan Africa to the United States. Using a qualitative thematic analysis, I explore how sexuality education changed first with colonialism, through migration, and to resettlement in the United States. I then explore how, beginning with puberty, Sub-Saharan African refugee and immigrant women learn about menstruation and sex, and the role of social media in their sex lives. I highlight the role of consistent and comprehensive sexuality education of women in understanding and experiencing their menstruation. Additionally, I discuss how Sub-Saharan African women learn about sex and pleasure from both male and female peers. And finally, I illustrate how Sub-Saharan African women create culturally relevant and religiously specific online counterpublics to discuss and learn about sex. Understanding how Sub-Saharan African immigrant women learn about sex has implications for sexuality education policy in the United States and the role of pleasure in sexual and reproductive health.
ContributorsRoss, Janet Nalubega (Author) / Estrada, Emir (Thesis advisor) / Gaughan, Monica (Thesis advisor) / Villegas-Gold, Michelle (Committee member) / Walker, Shawn (Committee member) / Arizona State University (Publisher)
Created2022
Description
Contact tracing was deployed widely during the COVID-19 pandemic to attempt to stop the spread of SARS Co-V-2. This dissertation investigates the research on contact tracing from a scientometric perspective and looks qualitatively at how case investigators and contact tracers conducted public health practice during the pandemic. Through approaching the public health practice of contact tracing from both a broad, top-down angle, and an on the ground experiential approach, this dissertation provides insight into the issues facing contact tracing as a public health tool.
ContributorsWhite, Alexandra C. (Author) / Jehn, Megan (Thesis advisor) / Hruschka, Daniel (Committee member) / Gaughan, Monica (Committee member) / Arizona State University (Publisher)
Created2022
Description
In this dissertation, I examine how social perceptions of physical disability shape interactions in healthcare. Drawing upon the lived experience and insights of Diné (Navajo) individuals with physical disabilities, family members, and Diné
on-indigenous healthcare workers and service providers, I explore the interrelationship of social perceptions of physical disability with understandings of identity and performance of personhood. Embedded within discourses and critiques of ableism/disablism, narratives highlight the interconnection of constructs of personhood and productivity.
Findings show that social perceptions of physical disability are closely linked to broader cultural norms surrounding concepts of health/illness. I offer a critical analysis of contemporary impacts of colonization and historical trauma on the physical, emotional, sociocultural and economic wellbeing of Diné people and those who fill service provision roles for this diverse population. Situated within broader contexts of defining constructs of ‘Whiteness’ and ‘Indigeneity’, the role of culture and discourses regarding stereotypes are particularly prominent factors in shaping relationships.
This interdisciplinary ethnography brings together contributions from Anthropology, Disability Studies, and Indigenous paradigms. Placing a particular emphasis on the social dynamics in two urban centers in the state of Arizona, this ethnography centers on analyzing areas of medical practice that work well, as well as gaps in the provision of healthcare services, with a particular focus on systemic and infrastructural barriers. These concerns are shared not only by Diné individuals with
physical disabilities and family members, but also by non-indigenous service providers and healthcare professionals.
on-indigenous healthcare workers and service providers, I explore the interrelationship of social perceptions of physical disability with understandings of identity and performance of personhood. Embedded within discourses and critiques of ableism/disablism, narratives highlight the interconnection of constructs of personhood and productivity.
Findings show that social perceptions of physical disability are closely linked to broader cultural norms surrounding concepts of health/illness. I offer a critical analysis of contemporary impacts of colonization and historical trauma on the physical, emotional, sociocultural and economic wellbeing of Diné people and those who fill service provision roles for this diverse population. Situated within broader contexts of defining constructs of ‘Whiteness’ and ‘Indigeneity’, the role of culture and discourses regarding stereotypes are particularly prominent factors in shaping relationships.
This interdisciplinary ethnography brings together contributions from Anthropology, Disability Studies, and Indigenous paradigms. Placing a particular emphasis on the social dynamics in two urban centers in the state of Arizona, this ethnography centers on analyzing areas of medical practice that work well, as well as gaps in the provision of healthcare services, with a particular focus on systemic and infrastructural barriers. These concerns are shared not only by Diné individuals with
physical disabilities and family members, but also by non-indigenous service providers and healthcare professionals.
ContributorsVarvarezou, Dimitra (Author) / Maupin, Jonathan N (Thesis advisor) / Gaughan, Monica (Committee member) / Williams, Deborah (Committee member) / Arizona State University (Publisher)
Created2020
Description
ABSTRACT
Background: As more adult intensive care units embrace open visitation policies and family-centered care, it becomes increasingly important to understand how the physical environment can best support family members while they navigate the critical illness or injury of a loved one. However, recommendations for the design of family-supportive spaces are typically anecdotal, and there is a paucity of empirical research regarding which design features best support their spatial needs. Purpose: The aim of this study was to develop instruments by which to evaluate the ability of affordances within the physical environment to support the spatial needs of family members of critically-ill patients (i.e., environmental congruence). Methods: An exploratory sequential design approach was used to explore the phenomenon and developed instruments by which to measure congruency. A thorough understanding was sought of the needs and experiences of family members within adult intensive care units, and a scoping review was conducted to reveal recommended environmental affordances for these settings. Results: From an a priori list of affordances, three instruments were developed. The Environmental Affordance Index was developed to evaluate the physical attributes within a given setting, and it formed the basis for two surveys to evaluate the spatial needs of family members. The Spatial Needs Inventory asks family members to rank the importance of recommended affordances for spaces within adult intensive care unit. The Spatial Needs Met survey provides an opportunity for family members to indicate if a given setting met their spatial needs. Conclusion: Future findings from the Environmental Affordance Index and survey instruments can potentially foster family-centered care, improve the design of adult intensive care units, influence visitation policies, and enhance family member well-being.
ContributorsGill, Rebecca Ann (Author) / Bender, Diane (Thesis advisor) / Gaughan, Monica (Committee member) / Brooks, Kenneth (Committee member) / Arizona State University (Publisher)
Created2023