Awarded Collaborative Faculty Seed Grants, 2014
An ASRI Partnership for Building Data Archiving Capacity
Samuel Annim, University of Cape Coast, Ghana
Lynn Woolfrey, University of Cape Town, South Africa
George Alter, ICPSR, University of Michigan
Background: The University of Cape Coast has launched a new center to archive and share data. The Inter-university Consortium of Political and Social Research (ICPSR) at the University of Michigan and DataFirst at the University of Cape Town, which are world-leading centers in social science data archiving, will offer advice, training and resources to assure the success of UCC’s new Centre for Data Archiving, Management, Analysis and Advocacy (DAMAA).
Methods: ICPSR and DataFirst will share policies, procedures, and technologies with DAMAA. Face-to-face meetings of Co-PIs will share information and planning. Staff from DAMAA will receive training at ICPSR and DataFirst.
Anticipated results: The long-run success of DAMAA depends upon providing valuable services to UCC faculty, students, and other stakeholders. By leveraging the experience and resources at ICPSR and DataFirst, DAMAA will rapidly move from planning to operation.
Significance: This project will be a model for future collaborations to build data management and archiving capacity in Africa and other places. Many valuable datasets are under-analyzed and lost, because of poor data management. Archiving and sharing these data is a benefit to the faculty and students of universities like UCC as well as the broader research and policy communities. We expect that lessons learned in establishing DAMAA will guide similar efforts elsewhere, and that DAMAA will join ICPSR and DataFirst in mentoring future data archives.
Outcomes: The website for the Centre for Data Archiving, Management, Analysis and Advocacy (DAMAA) can be visited at this location: http://cdamaa.ucc.edu.gh/
Cultural Adaptation of Trauma and Grief Measures for Ugandan Youth: Using “Best Practice” Test Construction
Janet Nakigudde, Makerere University, Uganda
Bruno Giordani, Medical School, University of Michigan
Background: Students in socially and economically disadvantaged Ugandan communities are frequently exposed to traumatic events and losses. Anecdotal evidence suggests that these experiences are not only rampant, but have a detrimental impact on students’ psychological functioning, including school behavior and academic performance. The introduction by DSM-5 of a new diagnosis, Persistent Complex Bereavement Disorder (PCBD), as well as a revision to the Posttraumatic Stress Disorder (PTSD) diagnosis, creates an unprecedented opportunity to develop “best practice” assessment tools to identify bereaved and/or traumatized youth who are experiencing severe persisting psychological distress and are at risk for developmental derailment. To date, the majority of studies supporting the inclusion of PCBD and revisions to PTSD in the DSM-5 were drawn from samples of Caucasian adults. Little is known about how either disorder manifests in youth, particularly Ugandan youth. An essential first step toward developing evidence-based interventions involves the construction of culturally sensitive assessment tools that are validated for the specific applications, populations, and settings for which they will be used.
Methods: We aim to adapt and validate two new scales – the Multidimensional Grief Reactions Scale (MGRS) and the UCLA PTSD Reactions Index DSM5 Version – for use in Ugandan primary schools. We will assess 500 youth, ages 8 to 14, attending Ugandan primary schools. We will utilize both qualitative and quantitative analytic methods.
Anticipated Results: This project will serve as a needs assessment and help to produce culturally appropriate, reliable, and valid trauma and grief measures for Ugandan youth.
Significance: The development of culturally sound measures of trauma and grief will allow for the possibility of screening Ugandan youth in schools and identifying those who may be in need of psychosocial treatment. This will serve as the basis for a larger NIH grant designed to implement an assessment-driven trauma- and grief-focused intervention for schools.
Improving Understanding of Maternal and Neonatal Mortality through Social Autopsy in Ghana
Raymond Aborigo, Navorongo Health Research Centre, Ghana Health Service, Ghana
Cheryl A. Moyer, Department of Medical Education, University of Michigan
Background: Each year, nearly 275,000 women die of pregnancy-related causes, and nearly 4 million babies die within their first month of life. Understanding why mothers and babies are dying is critical to reversing this trend, yet focusing solely on clinical causes of death missed important social and cultural antecedents. “Social Autopsy” is an emerging technique designed to enhance our understanding of the context of maternal and neonatal deaths, yet current tools are insufficient to adequately capture the range of factors at play.
Methods: We propose to develop and pilot test a qualitative interview guide to assess the most prominent social, cultural, and behavioral factors that impact maternal and neonatal deaths. Our final instrument will be administered to all family members in the Kassena Nankana District of rural northern Ghana who have lost an infant or a pregnant woman within the previous year, an estimated 70 families. Interviews will be transcribed and coded to identify a comprehensive list of the social and cultural domains of influence
Anticipated results: This project will result in a finalized qualitative Social Autopsy instrument that can be used to determine locally-relevant social and cultural factors that impact maternal and neonatal deaths. We will also identify those factors of greatest significance in northern Ghana, which we will present to decision-makers within the Ghana Health Service.
Significance: This study has the potential to fundamentally change the dialogue around social autopsy. The current paradigm focuses on clinical care-seeking behaviors, yet we believe this medico-centric model misses important determinants of illness itself. In addition, social autopsy has not yet been widely used or widely supported by granting agencies. ASRI’s support of this small grant has the potential to serve not only a catalyst for innovation, but also as a catalyst for significant extramural funding in the future.
Outcomes: This project sought to improve our understanding of the social and cultural factors that may contribute to maternal and neonatal deaths in rural northern Ghana by adapting existing Social Autopsy tools to generate more in-depth, qualitative responses. (Anatomical autopsies use pathologists and lab tests to yield a clinical cause of death; without such resources, Verbal Autopsies are conducted by interviewing family members to determine the most likely clinical cause of death based on symptoms; Social Autopsies attempt to uncover the social and cultural factors that may have contributed to that cause of death.)
As we began the process of adapting existing tools, we obtained additional funding from USAID-Ghana to implement a three-year, four-district social autopsy and GIS-based project known as PREMAND, or PREventing Maternal And Neonatal Deaths. This project vastly expanded the scope of the initial pilot project funded by ASRI, and we are just beginning Year 3 of that project. To date we have identified nearly 200 neonatal deaths in the region and approximately 30 maternal deaths and have conducted in-depth quantitative and qualitative social autopsy assessments with family members associated with each event. Results are pending the completion of data collection (Winter 2017) and analysis.
PREMAND team having a meeting
Publications associated with PREMAND thus far include:
- Moyer CA, Aborigo RA, Kaselitz EB, Gupta ML, Oduro A, Williams J. PREventing Maternal And Neonatal Deaths (PREMAND): A study protocol for examining social and cultural factors contributing to infant and maternal deaths and near-misses in rural northern Ghana. Reproductive Health. 2016; 13:20. doi 10.1186/s12978-016-0142-z
Presentations associated with PREMAND include the following:
- Moyer CA. “Maltreatment, Social Support, and Social Autopsy: An in-depth look at maternal and newborn health in Ghana.” University of Bergen, Bergen, Norway. May 19-20, 2016.
- Moyer CA: Using GIS and Social Autopsy to Understand Where and Why Women and Babies are Dying in Rural Northern Ghana. A presentation to the Center for Bioethics and Social Science Research at the University of Michigan. November 3, 2016.
- Moyer CA, Aborigo RA, Kaselitz E, James K, Chatio S, Williams J. PREventing Maternal and Neonatal Deaths in Rural Northern Ghana (PREMAND): Using Social Autopsy and GIS to Understand Neonatal Deaths and Near Misses. Consortium of Universities for Global Health Annual Meeting, Washington DC, April 2017.
- Kaselitz E, Moyer CA, Aborigo RA, James K, Chatio S, Williams J. PREventing Maternal and Neonatal Deaths in Rural Northern Ghana (PREMAND): Access to Basic and Comprehensive Emergency Obstetric Care. Consortium of Universities for Global Health Annual Meeting, Washington DC, April 2017
Stigma as a Barrier to Adolescent Family Planning in Ghana
Abubukar Manu, University of Ghana, Ghana
Kelly Stidham Hall, Population Studies Center, University of Michigan
Background: Adolescent unintended pregnancy rates are exceedingly high in Africa and contribute to a host of adverse consequences including maternal mortality. Despite awareness of and perceived access to family planning methods and services in countries like Ghana, the prevalence of modern contraception is low and declining. While many determinants of contraceptive nonuse and unintended pregnancy have been researched, little is known about whether and how social stigma, that is, negative attitudes and perceived norms of adolescent sexuality, contraception, pregnancy, childbearing and abortion, shapes family planning experiences among young women in Africa. This study examines stigma as a barrier to modern contraception and family planning service utilization among Ghanaian young women.
Methods: We propose to conduct a cross-sectional, multi-site, community-based survey study in Ghana. We will recruit 400 women aged 15-24 years attending senior high schools, universities and health centers in Accra and Kumasi. The structured, interviewer-guided, computerized survey will collect information on sociodemographic characteristics, health and social wellbeing, family planning knowledge, attitudes, and perceived norms, reproductive histories, and contraception and family planning service experiences. Outcomes are current modern contraceptive method use and family planning service utilization in the past 12 months. We will develop and validate a new family planning stigma cumulative index scale based upon a comprehensive set of adolescent family planning attitude and perceived norms measures.
Anticipated Results: Results from this study will illuminate how complex social factors, specifically stigma, influence adolescents’ family planning decision-making, behaviors, and outcomes in Ghana. Findings will permit a more broad understanding of the individual-, community-, and health systems-level determinants of young African women’s reproductive health.
Significance: This research will inform a subsequent larger study on barriers to adolescent family planning in Africa and identify factors to target in public health interventions to increase modern contraception uptake and reduce adolescent unintended pregnancy worldwide.