Browsing by Author "Rashid, Hira"
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Item Assessing the impact of 'Pakistan initiative for mothers and newborns' in comparison to socio-economic determinants of maternal health seeking in Pakistan(University of Delaware, 2015) Rashid, HiraEfficacy of behavioral interventions to improve maternal health seeking behavior (MHSB) has been increasingly scrutinized, particularly in developing countries like Pakistan. The purpose of this study is to analyze the impact the Pakistan Initiative for Mothers and Newborns (2004-2010) in 22 exposure districts compared to districts with no intervention. The impact of socioeconomic and demographic indicators in comparison to that of the intervention is also discussed in this paper. Data were obtained from the Pakistan Living Standards Measurement Survey 2004-05 and 2012-13.The sample consisted of 54706 women of reproductive age (15-50 years), from 22 intervention districts, and 72 control districts. Five utilization oriented indicators of MHSB were investigated; antenatal visits, tetanus toxoid vaccinations, health facility birth, skilled birth attendance and postnatal care. Using the Difference in Differences technique, binary logistic regression was used to assess the impact of PAIMAN relative to socioeconomic and demographic variables. We find that the PAIMAN intervention had no significant impact on improving likelihood of women seeking maternal health care. With the exception of prenatal care, there were no statistically significant differences in the odds of women utilizing maternal health services in the intervention districts in comparison to the control districts.Item Health and vulnerability among internally displaced persons in Burundi and Somalia(University of Delaware, 2020) Rashid, HiraThe number of internally displaced persons (IDPs) around the world today is greater than at any point in human history. IDPs represent some the most vulnerable population groups and have specific needs stemming from their displacement experiences. The inability to meet these needs can have implications for their overall wellbeing and impede their efforts to effectively resolve their displacement. Despite the existence of a substantial body of literature on internal displacement, research on approaches to identify the context-specific conditions that exacerbate vulnerability among IDPs is lacking. This dissertation aims to fill this gap in research by demonstrating the utility of a public health approach to the understanding of vulnerability among IDPs in Burundi and Somalia. ☐ Poor health is an essential aspect of overall vulnerability and has been attributed to many of the same underlying displacement related conditions that lead to increased vulnerability among IDPs. This dissertation proposes that using public health concepts to identify the social determinants of health among displaced populations can provide key insights into the understanding of conditions that exacerbate vulnerability. The research approach to demonstrate the proposed overlap between health and vulnerability included the examination of two separate data sources. First, secondary data collected from IDP settlements in Burundi and Hargeisa (Somalia) were analyzed using regression models and latent class analyses to identify the conditions that impact IDP’s health status, access to healthcare services and displacement resolution planning as well as to explore the determinants of overall vulnerability. Second, a content analysis of literature produced by key policy actors and stakeholders was conducted to determine the extent to which the conditions that lead to poor health and increased vulnerability among displaced populations are recognized in the displacement narrative relevant to Burundi and Somalia. The research designs of the statistical and content analyses were grounded within Vulnerable Populations Approach (VPA) and existing literature on health and vulnerability among IDPs. ☐ The findings of the statistical analysis showed that social determinants of health are key drivers of health status among IDPs in Burundi and Somalia. Furthermore, several indicators of health status also impacted access to healthcare services and influenced IDP’s decision making processes related to displacement resolution. Notably, there was substantial overlap between the conditions that influence the health aspects of displacement and those that lead to increased vulnerability among IDPs. Findings from the content analysis showed that while gaps remain with respect to the systematic examination of conditions that shape health and vulnerability in displacement contexts, over half of the indicators of poor health are recognized to influence overall vulnerability among IDPs. ☐ The use of a public health approach in displacement research can facilitate the understanding of displacement related vulnerabilities among IDPs. This can allow humanitarian and policy actors to devise effective interventions aimed at improving IDP’s wellbeing and facilitating the achievement of sustainable displacement resolution.Item Optimizing Health Outcomes for Children with Asthma in Delaware(Center for Community Research & Service, 2015) McDuffie, MaryJoan; Knight, Erin; Rashid, Hira