Cary Karp
Datos Biográficos
| ID | 1411094 |
|---|---|
| NOMBRE | Cary Karp |
| NOMBRES | Cary |
| APELLIDO | Karp |
| FIRMA | KARP C |
| AFILIACIONES | Johns Hopkins University |
| ORCID | 0000-0002-4050-7602 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 22 |
| TOTAL DE CITAS | 29 |
| TOTAL COMO AUTOR | 22 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1993 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2025 |
| ÍNDICE H | 3 |
Agency and Opportunity in Early Adolescence
INTRODUCTION: Little research has explored the relationship of opportunity structures, such as parental influence and neighborhood context, with the development of individual agency amongst adolescents, particularly in understanding gender-specific relationships. METHODS: We use longitudinal data from 1188 boys and 1153 girls who were age 10-14 at enrollment and followed for up to 5 years during the Global Early Adolescent Study in Kinshasa, DRC …
Keeping the “R” in Larc (long-acting reversible contraception)
As the use of subdermal contraceptive implants increases across sub-Saharan Africa, the need for person-centered removal services is more critical than ever to safeguard reproductive autonomy. In 2016, Christofield and Lacoste proposed eight conditions for client-centered implant removal, yet the extent to which these conditions have been assessed in large-scale surveys remains unexamined. Our mapping exercise collates survey information from thr…
Evaluating Contraceptive Empowerment Among Women and Girls in Sub‐Saharan Africa
This study evaluates the contraceptive empowerment subscale of the Women's and Girls’ Empowerment in Sexual and Reproductive Health (WGE‐SRH) index across seven sub‐Saharan African countries. Using structural equation modeling and logistic regression among population‐based samples of women aged 15–49, we find evidence that the abbreviated eight‐item subscale is a reliable measure of contraceptive empowerment (Cronbach's alpha range: 0.67–0.78), s…
A qualitative exploration of reproductive coercion experiences and perceptions in four geo-culturally diverse sub-Saharan African settings
Reproductive coercion (RC) is any intentional behavior that interferes with another's reproductive decision-making or pregnancy outcome. This study aims to qualitatively examine RC experiences and perceptions among women and men in Ethiopia, Nigeria (Kano and Anambra States), and Uganda. This is a secondary analysis utilizing qualitative data from the Women's and Girls' Empowerment in Sexual and Reproductive Health study. Across sites, focus grou…
Identifying what contraceptive side effects women are told about during counseling using nationally representative PMA Ethiopia 2019 cross-sectional data
Despite widespread concerns about contraceptive side effects among contraceptive users, few studies explore the specific side effects women are told about during contraceptive counseling. It is thus unclear whether women receive appropriate and sufficient information on side effects they may experience. The objective of this study is to describe which specific side effects of hormonal contraception or copper IUD users are counseled on and identif…
Abortion information-seeking experiences among women who obtained abortions in Kinshasa, DRC
Little is known about the process of seeking information related to abortion care options among women in the Democratic Republic of Congo (DRC). Understanding how women obtain information can help identify opportunities for intervention to increase awareness and use of safe pregnancy termination options. Using qualitative data collected from women in Kinshasa, DRC who reported having an abortion in the last 10 years, this study aims to determine …
Family planning service disruptions in the first two years of the Covid-19 pandemic
Many speculated that COVID-19 would severely restrict the delivery of essential health services, including family planning (FP), but evidence of this impact is limited, partly due to data limitations. We use cross-sectional data collected from regional and national samples of health facilities (n = 2,610) offering FP across seven low- and middle-income countries (LMICs) between 2019 and 2021, with longitudinal data from four geographies, to exami…
Trajectories of personal agency by gender and pubertal development among adolescents in Kinshasa
Young people develop/acquire different forms of agency at different stages of adolescence and development is not uniform across forms. Gender inequalities in agency amplify at puberty, signaling the need to intervene at or before this critical stage of development
Change in Fertility Intentions in the First Year of Covid-19
Recent evidence suggests that women in high-income countries desired to delay or forgo childbearing due to COVID-19, yet there remains insufficient evidence of COVID-19's impact on fertility desires in low- and middle-income countries, particularly in sub-Saharan Africa (SSA). We examined how quantum and tempo of fertility intentions changed in the first year of COVID-19 and assessed the impact of economic insecurity and sociodemographic characte…
What is the relationship between contraceptive services and knowledge of abortion availability and legality? Evidence from a national sample of women and facilities in Ethiopia
In Ethiopia, abortions are legal for minors and for rape, incest, foetal impairment or maternal disability. Knowledge of abortion legality and availability is low, and little effort has been made to disseminate this information for fear of invoking anti-abortion sentiment; instead, systems rely on health providers as information gatekeepers. This study explores how exposure to and interaction with family planning service delivery environment, spe…
Contraceptive Intentions and Use throughout the Extended Postpartum Period
The postpartum period is an ideal time for women to access contraception, but the prevalence of postpartum contraceptive use remains low in sub‐Saharan Africa. To better understand the gap between women's desires to space or limit births and their contraceptive behaviors, intention to use contraception has been proposed as a person‐centered measure of contraceptive demand. Using data from a panel study of Ethiopian women aged 15–49 who were inter…
Validation and Predictive Utility of a Person‐Centered Quality of Contraceptive Counseling (QCC‐10) Scale in Sub‐Saharan Africa
The lack of validated, cross‐cultural measures for examining quality of contraceptive counseling compromises progress toward improved services. We tested the validity and reliability of the 10‐item Quality of Contraceptive Counseling scale (QCC‐10) and its association with continued protection from unintended pregnancy and person‐centered outcomes using longitudinal data from women aged 15–49 in Burkina Faso, Kenya, and Nigeria. Psychometric anal…
Exploring Multiple Measures of Pregnancy Preferences and Their Relationship with Postpartum Contraceptive Uptake Using Longitudinal Data from PMA Ethiopia
There are significant gaps in our understanding of how the experience of an unintended pregnancy affects subsequent contraceptive behavior. Our objective was to explore how three measures of pregnancy preferences—measuring timing‐based intentions, emotional orientation, and planning status—were related to the uptake of postpartum family planning within one year after birth. Additionally, we tested whether the relationship between each measure and…
Stability and change in fertility intentions in response to the Covid-19 pandemic in Kenya
Fertility intentions are expected to decline due to the COVID-19 pandemic but limited empirical research on this topic has been conducted in sub-Saharan Africa. Longitudinal data from Kenya, with baseline (November 2019) and follow-up (June 2020) data, were used to 1) assess the extent to which individual-level fertility intentions changed, and 2) examine how security, specifically economic and health security, affected fertility intentions. The …
Fostering Protective Assets Among Syrian Refugee Girls Who Experience Child Marriage
Effect of the Covid-19 pandemic on health facility delivery in Ethiopia; results from PMA Ethiopia’s longitudinal panel
Objectives To examine the effect of COVID-19 on health facility delivery in Ethiopia. Design We used longitudinal data with a pre-post exposure to the pandemic to assess change in facility delivery patterns nationally and by urban and rural strata. We conducted design-based multivariable multinomial logistic regression comparing home, lower-level facility, and hospital delivery with date of birth as a spline term, with a knot indicating births be…
A sexual and reproductive empowerment framework to explore volitional sex in sub-Saharan Africa
Volitional sex is central to the sexual health and well-being of women and girls globally. To date, few studies have examined women's empowerment and its application to sexual health outcomes, including volitional sex. The aim of this study was to explore the relevance of a sexual and reproductive empowerment framework to volitional sex across four geographically and culturally diverse contexts in sub-Saharan Africa. Qualitative data were collect…
Family Planning Beliefs and Their Association with Contraceptive Use Dynamics
Norms and beliefs toward contraception, both positive and negative, motivate contraceptive use; however, they have seldom been explored longitudinally in low‐ and middle‐income countries, limiting our understanding of their influence on contraceptive dynamics. We used PMA2020 Uganda national longitudinal data of reproductive aged women in 2018 (baseline) and 2019 (follow‐up) to explore discontinuation and switching among modern contraceptive user…
Reconceptualizing Women's and Girls' Empowerment
CONTEXT: Improving women's empowerment is pivotal to public health and development programs; however, inconsistent definitions and lack of cross-cultural measures compromise monitoring efforts. METHODS: Data collected in 2017-2018 in Ethiopia, Uganda and two sites in Nigeria were used to develop a cross-cultural index of women's and girls' empowerment in sexual and reproductive health (WGE-SRH). Item development was grounded in qualitative interv…
Covert use of contraception in three sub-Saharan African countries
Results indicate that while covert use of contraception is common, continued covert use is challenging, especially when side effects manifest. Covert use may further suggest women taking independent action, symbolizing some level of empowerment. Results underscore the importance of disentangling unique reasons for covert use and the severity of repercussions of disclosure
I am the master key that opens and locks
The WGE-SRH framework is useful for exploring SRH empowerment, embracing the multilevel, dynamic nature of empowerment, as a process transitioning from existence of choice (autonomy) to exercise of choice (self-efficacy, decision-making, negotiation), and, ultimately, to achievement of choice. Future research and programs related to SRH empowerment should distinguish between existence and exercise of choices to promote the health and well-being o…
Lutes, Viols and Temperaments
Introduction 1. Classifying temperaments 2. Pythagorean intonation 3. Equal temperament 4. Meantone temperament 5. Just intonation 6. Other schemes 7. Conclusions Appendices Bibliography Index.
I am the master key that opens and locks
The WGE-SRH framework is useful for exploring SRH empowerment, embracing the multilevel, dynamic nature of empowerment, as a process transitioning from existence of choice (autonomy) to exercise of choice (self-efficacy, decision-making, negotiation), and, ultimately, to achievement of choice. Future research and programs related to SRH empowerment should distinguish between existence and exercise of choices to promote the health and well-being o…
Change in Fertility Intentions in the First Year of Covid-19
Recent evidence suggests that women in high-income countries desired to delay or forgo childbearing due to COVID-19, yet there remains insufficient evidence of COVID-19's impact on fertility desires in low- and middle-income countries, particularly in sub-Saharan Africa (SSA). We examined how quantum and tempo of fertility intentions changed in the first year of COVID-19 and assessed the impact of economic insecurity and sociodemographic characte…
Validation and Predictive Utility of a Person‐Centered Quality of Contraceptive Counseling (QCC‐10) Scale in Sub‐Saharan Africa
The lack of validated, cross‐cultural measures for examining quality of contraceptive counseling compromises progress toward improved services. We tested the validity and reliability of the 10‐item Quality of Contraceptive Counseling scale (QCC‐10) and its association with continued protection from unintended pregnancy and person‐centered outcomes using longitudinal data from women aged 15–49 in Burkina Faso, Kenya, and Nigeria. Psychometric anal…
Contraceptive Intentions and Use throughout the Extended Postpartum Period
The postpartum period is an ideal time for women to access contraception, but the prevalence of postpartum contraceptive use remains low in sub‐Saharan Africa. To better understand the gap between women's desires to space or limit births and their contraceptive behaviors, intention to use contraception has been proposed as a person‐centered measure of contraceptive demand. Using data from a panel study of Ethiopian women aged 15–49 who were inter…
Family Planning Beliefs and Their Association with Contraceptive Use Dynamics
Norms and beliefs toward contraception, both positive and negative, motivate contraceptive use; however, they have seldom been explored longitudinally in low‐ and middle‐income countries, limiting our understanding of their influence on contraceptive dynamics. We used PMA2020 Uganda national longitudinal data of reproductive aged women in 2018 (baseline) and 2019 (follow‐up) to explore discontinuation and switching among modern contraceptive user…
Lutes, Viols and Temperaments
Introduction 1. Classifying temperaments 2. Pythagorean intonation 3. Equal temperament 4. Meantone temperament 5. Just intonation 6. Other schemes 7. Conclusions Appendices Bibliography Index.
Reconceptualizing Women's and Girls' Empowerment
CONTEXT: Improving women's empowerment is pivotal to public health and development programs; however, inconsistent definitions and lack of cross-cultural measures compromise monitoring efforts. METHODS: Data collected in 2017-2018 in Ethiopia, Uganda and two sites in Nigeria were used to develop a cross-cultural index of women's and girls' empowerment in sexual and reproductive health (WGE-SRH). Item development was grounded in qualitative interv…
Covert use of contraception in three sub-Saharan African countries
Results indicate that while covert use of contraception is common, continued covert use is challenging, especially when side effects manifest. Covert use may further suggest women taking independent action, symbolizing some level of empowerment. Results underscore the importance of disentangling unique reasons for covert use and the severity of repercussions of disclosure
I am the master key that opens and locks
The WGE-SRH framework is useful for exploring SRH empowerment, embracing the multilevel, dynamic nature of empowerment, as a process transitioning from existence of choice (autonomy) to exercise of choice (self-efficacy, decision-making, negotiation), and, ultimately, to achievement of choice. Future research and programs related to SRH empowerment should distinguish between existence and exercise of choices to promote the health and well-being o…
Effect of the Covid-19 pandemic on health facility delivery in Ethiopia; results from PMA Ethiopia’s longitudinal panel
Objectives To examine the effect of COVID-19 on health facility delivery in Ethiopia. Design We used longitudinal data with a pre-post exposure to the pandemic to assess change in facility delivery patterns nationally and by urban and rural strata. We conducted design-based multivariable multinomial logistic regression comparing home, lower-level facility, and hospital delivery with date of birth as a spline term, with a knot indicating births be…
A sexual and reproductive empowerment framework to explore volitional sex in sub-Saharan Africa
Volitional sex is central to the sexual health and well-being of women and girls globally. To date, few studies have examined women's empowerment and its application to sexual health outcomes, including volitional sex. The aim of this study was to explore the relevance of a sexual and reproductive empowerment framework to volitional sex across four geographically and culturally diverse contexts in sub-Saharan Africa. Qualitative data were collect…
Family Planning Beliefs and Their Association with Contraceptive Use Dynamics
Norms and beliefs toward contraception, both positive and negative, motivate contraceptive use; however, they have seldom been explored longitudinally in low‐ and middle‐income countries, limiting our understanding of their influence on contraceptive dynamics. We used PMA2020 Uganda national longitudinal data of reproductive aged women in 2018 (baseline) and 2019 (follow‐up) to explore discontinuation and switching among modern contraceptive user…
Stability and change in fertility intentions in response to the Covid-19 pandemic in Kenya
Fertility intentions are expected to decline due to the COVID-19 pandemic but limited empirical research on this topic has been conducted in sub-Saharan Africa. Longitudinal data from Kenya, with baseline (November 2019) and follow-up (June 2020) data, were used to 1) assess the extent to which individual-level fertility intentions changed, and 2) examine how security, specifically economic and health security, affected fertility intentions. The …
Fostering Protective Assets Among Syrian Refugee Girls Who Experience Child Marriage
What is the relationship between contraceptive services and knowledge of abortion availability and legality? Evidence from a national sample of women and facilities in Ethiopia
In Ethiopia, abortions are legal for minors and for rape, incest, foetal impairment or maternal disability. Knowledge of abortion legality and availability is low, and little effort has been made to disseminate this information for fear of invoking anti-abortion sentiment; instead, systems rely on health providers as information gatekeepers. This study explores how exposure to and interaction with family planning service delivery environment, spe…
Contraceptive Intentions and Use throughout the Extended Postpartum Period
The postpartum period is an ideal time for women to access contraception, but the prevalence of postpartum contraceptive use remains low in sub‐Saharan Africa. To better understand the gap between women's desires to space or limit births and their contraceptive behaviors, intention to use contraception has been proposed as a person‐centered measure of contraceptive demand. Using data from a panel study of Ethiopian women aged 15–49 who were inter…
Validation and Predictive Utility of a Person‐Centered Quality of Contraceptive Counseling (QCC‐10) Scale in Sub‐Saharan Africa
The lack of validated, cross‐cultural measures for examining quality of contraceptive counseling compromises progress toward improved services. We tested the validity and reliability of the 10‐item Quality of Contraceptive Counseling scale (QCC‐10) and its association with continued protection from unintended pregnancy and person‐centered outcomes using longitudinal data from women aged 15–49 in Burkina Faso, Kenya, and Nigeria. Psychometric anal…
Exploring Multiple Measures of Pregnancy Preferences and Their Relationship with Postpartum Contraceptive Uptake Using Longitudinal Data from PMA Ethiopia
There are significant gaps in our understanding of how the experience of an unintended pregnancy affects subsequent contraceptive behavior. Our objective was to explore how three measures of pregnancy preferences—measuring timing‐based intentions, emotional orientation, and planning status—were related to the uptake of postpartum family planning within one year after birth. Additionally, we tested whether the relationship between each measure and…
A qualitative exploration of reproductive coercion experiences and perceptions in four geo-culturally diverse sub-Saharan African settings
Reproductive coercion (RC) is any intentional behavior that interferes with another's reproductive decision-making or pregnancy outcome. This study aims to qualitatively examine RC experiences and perceptions among women and men in Ethiopia, Nigeria (Kano and Anambra States), and Uganda. This is a secondary analysis utilizing qualitative data from the Women's and Girls' Empowerment in Sexual and Reproductive Health study. Across sites, focus grou…
Identifying what contraceptive side effects women are told about during counseling using nationally representative PMA Ethiopia 2019 cross-sectional data
Despite widespread concerns about contraceptive side effects among contraceptive users, few studies explore the specific side effects women are told about during contraceptive counseling. It is thus unclear whether women receive appropriate and sufficient information on side effects they may experience. The objective of this study is to describe which specific side effects of hormonal contraception or copper IUD users are counseled on and identif…
Abortion information-seeking experiences among women who obtained abortions in Kinshasa, DRC
Little is known about the process of seeking information related to abortion care options among women in the Democratic Republic of Congo (DRC). Understanding how women obtain information can help identify opportunities for intervention to increase awareness and use of safe pregnancy termination options. Using qualitative data collected from women in Kinshasa, DRC who reported having an abortion in the last 10 years, this study aims to determine …
Family planning service disruptions in the first two years of the Covid-19 pandemic
Many speculated that COVID-19 would severely restrict the delivery of essential health services, including family planning (FP), but evidence of this impact is limited, partly due to data limitations. We use cross-sectional data collected from regional and national samples of health facilities (n = 2,610) offering FP across seven low- and middle-income countries (LMICs) between 2019 and 2021, with longitudinal data from four geographies, to exami…
Trajectories of personal agency by gender and pubertal development among adolescents in Kinshasa
Young people develop/acquire different forms of agency at different stages of adolescence and development is not uniform across forms. Gender inequalities in agency amplify at puberty, signaling the need to intervene at or before this critical stage of development
Change in Fertility Intentions in the First Year of Covid-19
Recent evidence suggests that women in high-income countries desired to delay or forgo childbearing due to COVID-19, yet there remains insufficient evidence of COVID-19's impact on fertility desires in low- and middle-income countries, particularly in sub-Saharan Africa (SSA). We examined how quantum and tempo of fertility intentions changed in the first year of COVID-19 and assessed the impact of economic insecurity and sociodemographic characte…
Agency and Opportunity in Early Adolescence
INTRODUCTION: Little research has explored the relationship of opportunity structures, such as parental influence and neighborhood context, with the development of individual agency amongst adolescents, particularly in understanding gender-specific relationships. METHODS: We use longitudinal data from 1188 boys and 1153 girls who were age 10-14 at enrollment and followed for up to 5 years during the Global Early Adolescent Study in Kinshasa, DRC …
Keeping the “R” in Larc (long-acting reversible contraception)
As the use of subdermal contraceptive implants increases across sub-Saharan Africa, the need for person-centered removal services is more critical than ever to safeguard reproductive autonomy. In 2016, Christofield and Lacoste proposed eight conditions for client-centered implant removal, yet the extent to which these conditions have been assessed in large-scale surveys remains unexamined. Our mapping exercise collates survey information from thr…
Evaluating Contraceptive Empowerment Among Women and Girls in Sub‐Saharan Africa
This study evaluates the contraceptive empowerment subscale of the Women's and Girls’ Empowerment in Sexual and Reproductive Health (WGE‐SRH) index across seven sub‐Saharan African countries. Using structural equation modeling and logistic regression among population‐based samples of women aged 15–49, we find evidence that the abbreviated eight‐item subscale is a reliable measure of contraceptive empowerment (Cronbach's alpha range: 0.67–0.78), s…
Global Maternal and Child Health (17 obras) · Medicine (17 obras) · Population (16 obras) · Sociology (15 obras) · Environmental health (14 obras) · Psychology (14 obras) · Adolescent Sexual and Reproductive Health (11 obras) · Demography (11 obras) · Family planning (11 obras) · Reproductive Health and Contraception (9 obras)