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Assessment of Measurements of ART Adherence in Central Mozambique Jilian A. Sacks, Ph.D., Immunology OBJECTIVE: To compare the measurement of adherence to anti-retroviral treatment (ART) obtained from patient self-reporting and pharmacy refill data. Correlation Between Self-Reported & Pharmacy Refill Adherence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],THANK YOU! Mark Micek and Kenneth Sherr provided invaluable guidance. Cynthia Pearson coordinated the original study and generated the psychosocial scales. Study funded by: Health Alliance International, PEPFAR and TAP BACKGROUND METHODS The Influence of Psychosocial Properties on Adherence, by Method CONCLUSIONS RESULTS METHODS, cont. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Method which Indicates Optimal Adherence when Discordant METHODS * p < 0.05 ** p < 0.01 *** p < 0.005

Evaluating Regional Disease Surveillance Networks Abby Vogus, MPAc, Evans School of Public Affairs, University of Washington This project is funded by the Rockefeller Foundation. Thanks to Ann Marie Kimball, Lead Evaluator. Additional support and research by Neil Abernethy, Sara Curran, Mary Kay Gugerty, Emiko Muzuki, Alicia Silva-Santisteban, Debra Revere, South East Asian Ministers of Education – TropMed, Nancy MacPherson and Laura Fischler. Background Evaluation Objectives Methods ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Funding & Acknowledgements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Collaborative Evaluation Disease Surveillance Network Mapping GOARN Members: Countries in red, other networks in green ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Beyond Stigma and Discrimination Understanding MSM in Guyana through Qualitative Assessment Molly (Martha) Jenkins [email_address] Introduction For the purpose of improving current behavioral change communication (BCC) interventions implemented by the Ministry of Health and local NGOs, a qualitative assessment of males who have sex with other males (MSM) was conducted in Guyana Regions 4 and 6. Data from in-depth interviews (IDIs) and focus group discussions (FGDs) suggest that MSM in Guyana can best be understood as being highly diverse in terms of their profiles, behavior, experiences, and attitudes—though some differences appear systematic by region . Acknowledgements Assessment supported by the Guyana HIV/AIDS Reduction and Prevention Project—a four-year MSH and USAID-funded technical assistance project. Special Thanks to Shaundell Shipley and Clarence Perry at GHARPII. ,[object Object],[object Object],[object Object],[object Object],[object Object],Table 1. Overview of MSM Respondent Demographics ,[object Object],[object Object],[object Object],[object Object],[object Object],Category Description (number of respondents) Ages Range: 16-61, Mean: Approximately 26 Occupations (paid and unpaid) Cane cutters; cricket club managers; estate workers; fashion designer; office reception clerk; bartender; actor; product tester; teacher in a prison; sales representative; clerk; lab technician; sex workers (2); government employee; social worker; politician; radiologist; high-end hotel manager; community project supervisor; peer educators (9); unemployed (7) Ethnicity Indo-Guyanese (26); Afro-Guyanese (17); Amerindian (1); Mixed (18) Modal Orientation Tops (6); Bottoms (24); Versatile, versatile bottom (11); Unknown (21)

Women’s respiratory quality-of-life in relation to their cooking methods in Andean Bolivia Jacqueline Callihan Ph.D. Candidate, Department of Bioengineering, University of Washington. Project Mentor: Dr. Susan Bolton ,[object Object],[object Object],[object Object],Introduction and Purpose In indigenous villages in the Andean mountains of Bolivia, women cook mainly indoors on open fires, resulting in large quantities of smoke amassing in the kitchens and being breathed in over time. Members of the University of Washington Chapter of Engineers Without Borders (EWB-UWS) have been traveling to the Acacio canton (township) of Andean Bolivia since 2005 to implement improved cooking stoves, roofs, and chimneys that emit far less smoke than traditional open fires. Despite being well received, retaining high usage after completion, and being in high demand, the health impacts of this project had not been assessed until this study. The goal of this study was to determine the health related quality of life (HRQL) of women in rural Andean Bolivia in relation to their use of improved cooking stoves, roofs, and chimneys that have been designed and implemented by EWB-UWS. ,[object Object],[object Object],[object Object],Methodology In this study, a cross sectional comparative sampling of 44 women heads of household was performed via the St. Georges Respiratory Questionnaire (SGRQ) via a face-to-face health related quality of life interview. Four villages: Yanayo Chico, Cueva Pata, Tuquiza, and Ll’utara, were selected based on their use of indoor solid fuel for cooking and current or planned implementation, of EWB-UW designed stoves, roofs, and chimneys. The SGRQ is well established method to quantify health status in chronic pulmonary diseases and has been shown to correlate well with symptoms and disability due to disease. The SGRQ was pre-screened for culturally appropriate content, and then translated from Spanish into Quechua by interpreters during the face-to-face interview. Results were analyzed via SGRQ Analysis package for Microsoft Excel. Community Statistics Discussion SGRQ scores compared: Symptoms scores were significantly lower in women with the new stoves as compared to traditional stoves (23.0(24.6), vs. 53.3(19.5)) and the Total score (46.5(16.4) 58.5(15.5)) were significantly different (p<0.005 and p<0.05, respectively) SGRQ scores compared to other diseases: The mean Symptom, Activity, Impacts, and Total scores of similar healthy populations (with no lung disease) are: 9.7 13.4 4.7 8.4. Pneumoconiosis (due to inhalation of small dust particles from coal) in men in Hong Kong resulted in symptom, activity, impact and total scores of 38.0 (19.3), 44.5(21.9), 34.2 (17.9) and 39.4 (17.4), respectively. Both of these populations have significantly lower (better) SGRQ scores than women in both of the stove type groups. All subjects were non-smoking women heads of household from subsistence farming families p < 0.005 p < 0.05 with Student’s T-Test SGRQ Scores Future Studies Longitudinal studies to follow the health related quality-of-life of women villages of Tuquiza and Llu’tara post-implementation of the EWB designed stoves will further promote understanding of the health impacts of this project. The possibility of clinically significant improvements occurring over time between the same women pre-and post-implementation is promising, as more than 4 points decrease in scores was seen between the two groups currently studied. Additionally, increasing the sample size of women who have new stoves will further improve the statistical power of the study. Conclusions Women cooking on new stoves had significantly better (lower) SGRQ symptom and total scores than those cooking on traditional stoves. However, these scores are still much higher than healthy populations and populations suffering from Pneumoconiosis due to inhalation of coal dust indicating that indoor air pollution from poorly vented stoves causes extremely detrimental long term effects on women’s quality-of-life in the. Community Tuquiza Llutara Cueva Pata Yanayo Chico # of Households 29 12 8 5 # Analyzed 20 6 8 5 Average Age 49.1 44.1 49.0 36.0 Traditional Stoves 20 6 -- -- New Stoves -- -- 8 5

NGO Code of Conduct for Health Systems Strengthening: Sharing research findings and identifying future directions. Erin Hurley, MPHc ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Many thanks to my capstone adviser, Emily deRiel, MPH and to HAI

Re-Imagining Residential Care Facilities for Orphans and Vulnerable Children in Swaziland: A Case Study of Likhaya Lemphilo Lensha ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Thank you Michelle Desmond, MSW/MPHc, University of Washington, Laura Mitchell, MA, SPARK Center at Boston Medical Center, and Mary Jean Kopp, African Leadership Partners. This project was supported by the Health Economic HIV/AIDS Research Division at the University of Kwa-Zulu Natal. Forthcoming manual capturing the core components of the Likhaya project. Tegan Callahan, MPHc, Community-Oriented Public Health Practice Program, University of Washington Project Objective Document the structure and core components of the Likhaya Lemphilo Lensha project to create a case study in addressing the needs of children left without alternative care in Swaziland. Prepare resources project staff can share with interested stakeholders throughout Swaziland and the region. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Acknowledgements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Results Likhaya Lemphilo Lensha offers a model of excellence for providing care for children left without alternatives and mitigating social impacts of HIV. Likhaya Lemphilo Lensha is now equipped with a practical resource they can disseminate among stakeholders to offer guidance and inform best practices among the emerging ‘orphan care’ projects in Swaziland.

Assessing Community Needs for Action against Diabetes in Bangkok Public Housing Community Pornsak (Paul) Chandanabhumma, MPHc, Social and Behavioral Sciences, Department of Health Services Capstone Site : Pattana Medical Center Clinic, Bangkok, Thailand Adviser : Virginia Gonzales, MSW, EdD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Community Site Located in Eastern Bangkok, Subsinmai is a 420-household public housing community managed by the Crown Bureau Property since 1991. A primarily rental community, it registers 1,100 official residents but may house up to 4,000-5,000 people. Most work in service industries or are merchants/self-own businesses. About half the residents are females and half Buddhist ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Acknowledgements I would like to thank Dr. Luephorn Punnakanta ,Ornkingporn Srisak and the staff of PMC for providing resources and guidance to complete the capstone project. I am also grateful for my advisor, Dr. Virginia Gonzales, for her support. References Aekplakorn, W., Stolk, R.P., Neal, B., Suriyawongpaisal, P., Chongsuvivatwong, V., Cheepudomwi, S., Woodward, M. (2003). The Prevalence and Management of Diabetes in Thai Adults. Diabetes Care, 26 (10), 2758-2763. WHO (2002). Death and DALY Statistics by Cause. Retrieved from http://www.who.int/entity/healthinfo/statistics/bodgbddeathdalyestimates.xls Characteristic Type Number or % (95% C.I.) Gender Male Female 23.9% (11.1%, 36.7%) 76.1% (63.3%, 88.9%) Age Mean (Years) 46.3 (42.7, 50.0) Occupation None Merchant Service Other 26.1% (12.9%, 39.3%) 41.3% (26.5%, 56.1%) 13.0% (2.93%, 23.2%) 19.6% (7.65%, 31.5%) Education Primary Secondary Bachelor’s Degree None 47.8 % (32.8%, 62.8%) 30.4 % (16.6%, 44.2%) 15.2% (4.43%, 26.0%) 6.52% (0%, 13.9%)

Girls Leading Our World: After School Life Skills Training Program for Adolescent Girls in Botswana Chami Arachchi (MPH candidate, Dept. of Health Services, Uni. Washington, Seattle, WA, 2009) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Project Design Setting : Secondary School Target Population : 30 School girls, 13-18yrs old. Project type : After school club Intervention : 3hour Life Skills session once a week for 10months, homework during school holidays. Incentives for attendance & participation. Trainers : Local health educators and Peace Corps Volunteers. Funding : U.S. Peace Corps, The Chobe District AIDS Coordinating Office & the Chobe District Community ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Maternal and Child Health Census, Village of Bwiza, Rwanda Erin Barry, MA, MPHc, Community Oriented Public Health Practice, University of Washington Objectives Background Methodology Findings The Community of Potters (COP) are former hunter-gatherers that have been displaced from their traditional homelands and way of life. They comprise approximately 33,000 of Rwanda’s 10 million people. The COP are discriminated against, impoverished, and lack access to health care, water, and employment opportunities. They also suffer from negative stereotyping, denial of rights, and segregation. The Community of Potters Health and Development Project (COPHAD) is a joint project of Health Leadership International (HLI) in Seattle and Health Development Initiative in Kigali. HLI and HDI began working in the village of Bwiza in March, 2008 and view COPHAD as a pilot project—their goal is to expand health and development initiatives to other COP villages in Rwanda. Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Comparison of Bwiza Jan ‘09 Survey vs. Rwanda 2005 DHS 133 70 Child Survival in Bwiza, Jan ’09 (# of children born to Bwiza mothers) 63 (47%) 70 (53%) Died Survived ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ADDITIONAL TEAM MEMBERS Karl Weyrauch, MD, MPH, CIP, President of HLI Marisa Harrison, MPHc, Global Health, UW Carmen Washington, MSW, MPHc, COPHP, UW Funding Source: Health Leadership International Special thanks to my advisor, Dr. Mary Anne Mercer Indicator COP National % of mothers with children under age 5 who had some antenatal care 50% 94% % of mothers who had a skilled attendant at birth 13% 39% % of women who can read 48% 70% % of primary school age children (ages 7-12) attending primary school 93% 75% % of households for whom distance to water source is less than 15 minutes 0% 27% rural 47% urban % of households with access to toilet facilities 37% 95% rural 97% urban

[object Object],[object Object],[object Object],[object Object],[object Object],Characterization of Water Quality from Open and Rope Pump Wells in Kandal, Cambodia H.B. Bennett 1 , M. Sampson 2 , J.S. Meschke 1 1 Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, 2 Resource Development International, Phnom Penh, Cambodia ,[object Object],[object Object],[object Object],ACKNOWLEDGEMENTS We thank the Washington Global Health Alliance and Fogarty International Center for funding. H.B. wishes to thank the volunteers and staff at RDI for their assistance while in country, and their continued efforts towards the success of the project. ,[object Object],[object Object],[object Object],[object Object],[object Object],Figure 1: Open well (L) and rope pump well (R). Both open and rope pump wells typically reach 8-12m into the shallow aquifer and are 1m in diameter. Rope pump caps may be affixed to already dug open wells. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Figure 2: DWQI health related scoring of Rope Pump wells and Open Wells. Median score for each well from July - February, with minimum and maximum scores barred Figure 3: Minimum, mean, and maximum score for each well over the sampling period. Arsenic are measured discretely. When a health based standard has been set for a contaminant a dashed line has been place on the graph for reference. ,[object Object],[object Object],[object Object],E. coli (CFU/100mL) 3.0 1.0 3.0 5.0 1.0 RP-1 RP-2 RP-3 RP-4 RP-5 RP-6 RP-7 RP-8 RP-9 OW-1 OW-2 OW-3 OW-4 OW-5 OW-6 OW-7 OW-8 5.0 As (ppb) RP-1 RP-2 RP-3 RP-4 RP-5 RP-6 RP-7 RP-8 RP-9 50 30 10 OW-1 OW-2 OW-3 OW-4 OW-5 OW-6 OW-7 OW-8 x xx x x x x x x x x x X x x x xx x xx x x x x x 30 10 50

Development of Hepatitis B Educational Materials for Cambodian Americans Bora Chun, MSW and Global Health Graduate Certificate Student ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Acknowledgments: Dr. Vicky Taylor, Chandara Sos, Jocelyn Talbot, and Huyen Hoai Do; Fred Hutchinson Cancer Research Center (FHCRC); Dr. Jim LoGerfo, UW Global Health Department; and Cambodian Community Coalition members for their technical input, support, cooperation, and comments. ,[object Object],[object Object],[object Object],BE HEALTHY, LEARN ABOUT HEPATITIS B

The Consignment of Research Study Drugs to International Sites Jeanne Conley, MPH Candidate, School of Public Health, University of Washington Background HIV/AIDS in Uganda and Kenya remains a major public health issue despite increased availability of antiretroviral drugs for HIV+ people. Because the most common method of transmission in these countries is between serodiscordant couples, a study being conducted by the UW International Clinical Research Center (UW ICRC) is looking at the potential reduction of transmission by providing antiretroviral drugs to one member of the couple. The distribution of the study drug from the U.S. pharmaceutical company to Uganda and Kenya has turned out to be a complicated endeavor. Instead of following a direct path from the distributor to the research site, there are numerous points in the process where the shipment can be diverted or delayed. Each country has its own requirements for importation, the paperwork is extensive, and the sheer number of people involved in the process increases the complexity considerably. As Coordinating Center for the study, the UW ICRC needed a definitive, well-documented management plan to facilitate the distributive process. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Roles and Responsibilities ICRC Study Drug Distribution Coordinator (SDDC) Ensures that responsibilities are being carried out and that the shipments are on track . Pharmaceutical Company Provides study drug, oversees company’s regulations for shipping drug to foreign countries. Drug Consignment Center Maintains automated system to determine drug use at the sites and the need for more drug. Repository and Packager Packages study drug into blinded study drug kits; stores drug until needed. Contract Consultant Maintains blinded randomization code; works on other issues relating to study drug. Shipping Company Arranges for drug kits to be shipped from the U.S. to the African countries, with appropriate documentation . In-country Brokering Agent Receives shipment at port, pays duties, clears shipment through Customs, and forwards the shipment to the research sites. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Consignment (request for shipment) occurs Pro forma is sent to the research site by drug company. Site sends pro forma to NDA or Pharmacy & Poisons Board Shipper alerts in-country broker and ships packages Site receives permit and sends copy to ICRC & drug company Research drug is prepared for shipment by repository Broker pays taxes & provides documents Drug is cleared and transported to research site Shipment arrives, goes to Customs Conclusions Despite the development of a comprehensive distribution plan, careful monitoring of each transfer is necessary to ensure that it proceeds smoothly. Special thanks to Bill Lafferty, Health Services, and Margaret Warner-Lubin, International Clinical Research Center

Improving Spanish-spoken community health care access At HMC ---Improving interpreter services and Community House Calls Program Rui Lin, MHA Health Services ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Implementation of these two services: References: 1.U.S. Census Bureau.(2000). DP-2. Profile of Selected Social Characteristics: 2000 , Data Set: Census 2000 Summary File 3 (SF 3) - Sample Data from: US Census bureau 2.Regenstein.M, Mead.H, Muessig,K.E, Huang. J.(2008).Challenges in Language Services: Identifying and Responding to Patients’ Needs. J Immigrant Minority Health ,DOI 10.1007/s10903-008-9157-z. 3. Harborview Medical Center Overview. (2008). from: Harborview Medical Center official Web site: http://uwmedicine.washington.edu/Facilities/Harborview/Overview/

EthnoMed Somali Cultural Project: Mitigating Clinical Barriers in Dealing with Chronic/Terminal Illness and End-of-Life Issues Jessica Mooney, MAIS candidate ‘09 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Objectives: To identify and bridge existing clinical and cultural gaps between traditional notions of medical care in Somali society and western medical practice surrounding issues of chronic/terminal illness & end-of-life issues ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Methodology: Study Design: Qualitative study to examine perceptions of clinical care on issues pertaining to chronic/terminal illness and end-of-life issues in Seattle’s Somali community Study Instrument: Ethnographic interviews were conducted with Somali focus groups based on clinical and cultural information gathered from a preliminary literature review Rationale: Ethnography will help identify gaps and barriers in communication and understanding Somali patients encounter when confronted with chronic/terminal illness & end-of-life issues in a westernized medical system ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],* Harrell-Bond, Barbara E. 2002. Can humanitarian work with refugees be humane? Human Rights Quarterly 24, (1): 51-85.

Preventing HIV among Adolescent Victims of Commercial Sexual Exploitation in Lima, Per ú Kate Murray, MPHc Social & Behavioral Sciences Program, Health Services University of Washington Background Evaluation Design Commercial Sexual Exploitation of Children and Adolescents ( ESCIA in Spanish) is the sexual exploitation of children and adolescents by adults. ESCIA includes forcing minors to have sex for money, human trafficking for sex, and sexual abuse by adults. Factors such as family abuse, economic factors, and peer involvement drive children into ESCIA. Setting V í a Libre is a Peruvian non-governmental organization that combats the effects of HIV through prevention, treatment, and care for people living with HIV/AIDS. Proyecto IDEAL is an HIV/AIDS prevention program for adolescents who are currently involved in ESCIA. Participants in the programs are boys and girls, ages 13 to 19, in Lima. Thank you very much to my friends and mentors at V ìa Libre, most especially Lic. Ada Mejía, Judith, Sarita, Sonia, Walter, Maggie, Gustavo, Zulay, Leydee, y Yleana, and all of the teens. Les agradezco muchísimo. Proyecto IDEAL participants during a sexual health workshop. This project was possible due to the Amauta Peru Practicum Grant from the Washington Global Health Alliance. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Impact Evaluation Questions EDUCATION Human Rights Sexual Health Self Esteem Leadership HEALTH SERVICES COUNSELING SOCIAL WORKER SUPPORT Program Components ,[object Object],[object Object],[object Object],Anticipated Challenges Program Aims To promote favorable conditions to diminish the vulnerability to and the impact of ESCIA through public sensitization, victim empowerment and improving victims’ access to resources.

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Effects of ARV Regimens among Patients Initiated on HAART at Gondar University Hospital in Ethiopia Heather Pines, Department of Epidemiology, SPHCM, University of Washington

Mama Maria Clinic's Path to Sustainability: Managing Growth through Organizational Assessment, Strategic Planning and Financial Forecasting (Colin Walker, MHAc 2009) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Community Health Workers in Rural Kenya: Practices, Challenges and Evaluation By Cheryl Rudd, Candidate MPA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Health Assessment of Women and Children in Coastal Kenya: An Evaluation of the East African Center’s Community Health Worker Program By Merran O’Connor, MPA Candidate 2009 Purpose To conduct a program evaluation of a Community Health Worker (CHW) Program ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Population Total Interviewed : 209 Final Sample Size : 201 Interviews per village : Takaungu (45), Vuma (23), Kayanda (7), Kanyumbuni (5), Other (13) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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