Dilys Walker
Biographic Data
| ID | 3887581 |
|---|---|
| NAME | Dilys Walker |
| GIVEN NAMES | Dilys |
| FAMILY NAME | Walker |
| SIGNATURE | WALKER D |
| AFFILIATIONS | University of California, San Francisco |
| ORCID | 0000-0002-9599-388X |
| VERIFIED | Yes |
| TOTAL WORKS | 22 |
| TOTAL CITATIONS | 15 |
| AUTHOR COUNT | 22 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2004 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 3 |
A qualitative study of abortion decision-making trajectories among pregnant women at their first antenatal care visit in Kampala, Uganda
Background: In Uganda, only about half of women who want to avoid pregnancy are using modern contraceptives, leading to high numbers of unintended pregnancies and elevated maternal and neonatal morbidity and mortality. In this study, we aimed to learn more about women's abortion decision-making before continuing to carry a pregnancy. Methods: We utilised a qualitative study design and interviewed 31 purposively selected single and partnered pregn…
Association between coordinated counseling from both Asha and Anganwadi Workers and maternal health outcomes
Community Health Workers (CHWs) play crucial roles in health promotion and services in rural India. Previous research investigating the effectiveness of coordinated health promotion by different community health workers (CHWs) cadres on health practices is scarce. This study examines the effectiveness of coordinated health promotion by different CHW cadres, specifically Accredited Social Health Activists (ASHA) and Anganwadi Workers (AWW), on mat…
A cluster randomized controlled trial to assess the impact of the ‘Caring for Providers to Improve Patient Experience’ (CPIPE) intervention in Kenya and Ghana
ClinicalTrials.gov: NCT06085105. Protocol version and date: v2-11-07-23
Simulation and team training to improve preterm birth knowledge, evidence-based practices, and communication skills in midwives in Kenya and Uganda
Simulation training in basic and emergency obstetric and neonatal care has previously shown success in reducing maternal and neonatal mortality in low-resource settings. Though preterm birth is the leading cause of neonatal deaths, application of this training methodology geared specifically towards reducing preterm birth mortality and morbidity has not yet been implemented and evaluated. The East Africa Preterm Birth Initiative (PTBi-EA) was a m…
A comic based interactive digital intervention to enhance facilitation skills of nurse mentors in public facilities – results of a pilot intervention in Bihar, India
BACKGROUND: (SD)' to strengthen simulation educator's facilitation knowledge, skills, confidence, and engagement. This endline evaluation presents results on the change in knowledge after watching the episodes and retention of that knowledge over 10 months. OBJECTIVES: The objectives of this pilot study are to: 1) assess the change in knowledge between the baseline and post-episode surveys; and 2) understand the retention of knowledge between the…
Can digitally enabling community health and nutrition workers improve services delivery to pregnant women and mothers of infants? Quasi-experimental evidence from a national-scale nutrition programme …
BACKGROUND: India's 1.4 million community health and nutrition workers (CHNWs) serve 158 million beneficiaries under the Integrated Child Development Services (ICDS) programme. We assessed the impact of a data capture, decision support, and job-aid mobile app for the CHNWs on two primary outcomes-(1) timeliness of home visits and (2) appropriate counselling specific to the needs of pregnant women and mothers of children <12 months. METHODS: We us…
Effect of a quality improvement intervention for management of preterm births on outcomes of all births in Kenya and Uganda
Background: A large proportion of early neonatal deaths occur at the time or on the first day of birth. The Preterm Birth Initiative East Africa (PTBi EA) set out to decrease mortality among preterm births through improving quality of facility-based intrapartum care. The PTBi EA cluster randomized trial's primary analysis showed the package reduced intrapartum stillbirth and neonatal death among preterm infants. This secondary analysis examines t…
Super Divya, an Interactive Digital Storytelling Instructional Comic Series to Sustain Facilitation Skills of Labor and Delivery Nurse Mentors in Bihar, India—A Pilot Study
To improve the quality of intrapartum care in public health facilities of Bihar, India, a statewide quality improvement program was implemented. Nurses participated in simulation sessions to improve their clinical, teamwork, and communication skills. Nurse mentors, tasked with facilitating these sessions, received training in best practices. To support the mentors in the on-going facilitation of these trainings, we developed a digital, interactiv…
Self-reported provision of person-centred maternity care among providers in Kenya and Ghana
INTRODUCTION: Person-centred maternity care (PCMC), which refers to care that is respectful and responsive to women's preferences needs, and values, is core to high-quality maternal and child health. Provider-reported PCMC provision is a potentially valid means of assessing the extent of PCMC and contributing factors. Our objectives are to assess the psychometric properties of a provider-reported PCMC scale, and to examine levels and factors asso…
Provider perceptions of lack of supportive care during childbirth
Supportive care is a key component of person-centered maternity care (PCMC), and includes aspects such as timely and attentive care, pain control, and the health facility environment. Yet, few researchers have explored the degree of supportive care delivered or providers' perceptions on supportive care practices during childbirth. The researchers' aim is to evaluate the extent of supportive care provided to women during childbirth and to identify…
Improving primary health care delivery in Bihar, India
In 2010, the Bill and Melinda Gates Foundation (BMGF) partnered with the Government of Bihar (GoB), India to launch the Ananya program to improve reproductive, maternal, newborn and child health and nutrition (RMNCHN) outcomes. The program sought to address supply-and demand-side barriers to the adoption, coverage, quality, equity and health impact of select RMNCHN interventions. Approaches included strengthening frontline worker service delivery…
Simulation and team training embedded nurse mentoring programme and improvement in intrapartum and newborn care in a low-resource setting in Bihar, India
Background Improvement of the quality of maternal and child health care remains a focus in India. Working with the Government of Bihar, CARE-India facilitated a comprehensive set of quality of care improvement initiatives. PRONTO's simulation and team-training was incorporated into the largescale Apatkaleen Matritva evam Navjat Tatparta (AMANAT) nurse-mentoring program of the Government of Bihar supported by CARE-India to improve maternal and chi…
Measuring movement towards improved emergency obstetric care in rural Kenya with implementation of the PRONTO simulation and team training program
As the proportion of facility-based births increases, so does the need to ensure that mothers and their newborns receive quality care. Developing facility-oriented obstetric and neonatal training programs grounded in principles of teamwork utilizing simulation-based training for emergency response is an important strategy for improving the quality care. This study uses 3 dimensions of the Kirkpatrick Model to measure the impact of PRONTO Internat…
Professional midwifery in Guatemala
The Oportunidades Conditional Cash Transfer Program
CONTEXT: Oportunidades is a large conditional cash transfer program in Mexico. It is important to examine whether the program has any direct effect on pregnancy experience and contraceptive use among young rural women, apart from those through education. METHODS: Data from the 1992, 2006 and 2009 waves of a nationally representative, population-based survey were used to describe trends in pregnancy experience, contraceptive use and education amon…
Factors that influence communication about sexuality between parents and adolescents in the cultural context of Mexican families
Sexually transmitted infections and unplanned pregnancy among adolescents are important public health issues that can be tackled through the implementation of effective education strategies. Previous studies have documented the importance and effectiveness of parents as primary educators for their adolescents. A qualitative study based on grounded theory was undertaken in five different public high schools in Mexico and 33 interviews were carried…
Learning effect of a conditional cash transfer programme on poor rural women’s selection of delivery care in Mexico
Background The Mexican programme Oportunidades/Progresa conditionally transfers money to beneficiary families. Over the past 10 years, poor rural women have been obliged to attend antenatal care (ANC) visits and reproductive health talks. We propose that the length of time in the programme influences women’s preferences, thus increasing their use not only of services directly linked to the cash transfers, but also of other services, such as clini…
Bringing Two Worlds Together
Integrating traditional midwives (TMs) as labor support in cline-based care may be an ideal solution to improving maternity services in the Mexico and worldwide. We conducted interviews and focus groups with 65 TMs and 24 interviews with public health system personnel to assess the acceptability and challenges of this proposal. Both TMs and personnel perceive this new role as having professional benefits. Challenges include TMs' and clinic person…
First Steps Toward Successful Communication About Sexual Health Between Adolescents and Parents in Mexico
In this article reporting on our qualitative study, we describe changes in parent-adolescent sexual health communication following an intervention for parents of 10th graders in Mexico. The intervention was aimed to sensitize and develop skills for appropriate parent-child communication about the prevention of sexually transmitted infections (STIs), unplanned pregnancy, and birth control, and focused on encouraging condom use with emergency contr…
Educación sobre sexualidad y prevención del VIH
Sex education materials should be reviewed and updated periodically to reflect progress being made on the issues and the handling of the subject matter. In each country, the curriculum should address the issue of respecting differences in sexual orientation, preference, and identity, and especially, an appropriate approach toward sexually-transmitted infection (STI) prevention education among males who have sex with males. Efforts to assess the p…
Educating Skilled Birth Attendants in Mexico
Although the majority of births in Mexico are attended by skilled birth attendants, maternal mortality remains moderately high, raising questions about the quality of training and delivery care. We conducted an exhaustive review of the curricula of three representative schools for the education and clinical preparation of three types of birth attendant - obstetric nurses, professional midwives and general physicians - National Autonomous Universi…
Deaths from Complications of Unsafe Abortion
This study measured the contribution of abortion-related deaths to overall maternal mortality and calculated the underestimation of maternal mortality using verbal autopsy and clinical record review where available. We reviewed 807 death certificates of women aged 12—50 who died in 2001 in two sites of about 1.5 million inhabitants each in the state of Morelos (primarily rural) and the municipality of Nezahualcóyotl (primarily urban) in the state…
Learning effect of a conditional cash transfer programme on poor rural women’s selection of delivery care in Mexico
Background The Mexican programme Oportunidades/Progresa conditionally transfers money to beneficiary families. Over the past 10 years, poor rural women have been obliged to attend antenatal care (ANC) visits and reproductive health talks. We propose that the length of time in the programme influences women’s preferences, thus increasing their use not only of services directly linked to the cash transfers, but also of other services, such as clini…
Deaths from Complications of Unsafe Abortion
This study measured the contribution of abortion-related deaths to overall maternal mortality and calculated the underestimation of maternal mortality using verbal autopsy and clinical record review where available. We reviewed 807 death certificates of women aged 12—50 who died in 2001 in two sites of about 1.5 million inhabitants each in the state of Morelos (primarily rural) and the municipality of Nezahualcóyotl (primarily urban) in the state…
First Steps Toward Successful Communication About Sexual Health Between Adolescents and Parents in Mexico
In this article reporting on our qualitative study, we describe changes in parent-adolescent sexual health communication following an intervention for parents of 10th graders in Mexico. The intervention was aimed to sensitize and develop skills for appropriate parent-child communication about the prevention of sexually transmitted infections (STIs), unplanned pregnancy, and birth control, and focused on encouraging condom use with emergency contr…
Professional midwifery in Guatemala
Deaths from Complications of Unsafe Abortion
This study measured the contribution of abortion-related deaths to overall maternal mortality and calculated the underestimation of maternal mortality using verbal autopsy and clinical record review where available. We reviewed 807 death certificates of women aged 12—50 who died in 2001 in two sites of about 1.5 million inhabitants each in the state of Morelos (primarily rural) and the municipality of Nezahualcóyotl (primarily urban) in the state…
Educating Skilled Birth Attendants in Mexico
Although the majority of births in Mexico are attended by skilled birth attendants, maternal mortality remains moderately high, raising questions about the quality of training and delivery care. We conducted an exhaustive review of the curricula of three representative schools for the education and clinical preparation of three types of birth attendant - obstetric nurses, professional midwives and general physicians - National Autonomous Universi…
Educación sobre sexualidad y prevención del VIH
Sex education materials should be reviewed and updated periodically to reflect progress being made on the issues and the handling of the subject matter. In each country, the curriculum should address the issue of respecting differences in sexual orientation, preference, and identity, and especially, an appropriate approach toward sexually-transmitted infection (STI) prevention education among males who have sex with males. Efforts to assess the p…
Bringing Two Worlds Together
Integrating traditional midwives (TMs) as labor support in cline-based care may be an ideal solution to improving maternity services in the Mexico and worldwide. We conducted interviews and focus groups with 65 TMs and 24 interviews with public health system personnel to assess the acceptability and challenges of this proposal. Both TMs and personnel perceive this new role as having professional benefits. Challenges include TMs' and clinic person…
First Steps Toward Successful Communication About Sexual Health Between Adolescents and Parents in Mexico
In this article reporting on our qualitative study, we describe changes in parent-adolescent sexual health communication following an intervention for parents of 10th graders in Mexico. The intervention was aimed to sensitize and develop skills for appropriate parent-child communication about the prevention of sexually transmitted infections (STIs), unplanned pregnancy, and birth control, and focused on encouraging condom use with emergency contr…
Factors that influence communication about sexuality between parents and adolescents in the cultural context of Mexican families
Sexually transmitted infections and unplanned pregnancy among adolescents are important public health issues that can be tackled through the implementation of effective education strategies. Previous studies have documented the importance and effectiveness of parents as primary educators for their adolescents. A qualitative study based on grounded theory was undertaken in five different public high schools in Mexico and 33 interviews were carried…
Learning effect of a conditional cash transfer programme on poor rural women’s selection of delivery care in Mexico
Background The Mexican programme Oportunidades/Progresa conditionally transfers money to beneficiary families. Over the past 10 years, poor rural women have been obliged to attend antenatal care (ANC) visits and reproductive health talks. We propose that the length of time in the programme influences women’s preferences, thus increasing their use not only of services directly linked to the cash transfers, but also of other services, such as clini…
The Oportunidades Conditional Cash Transfer Program
CONTEXT: Oportunidades is a large conditional cash transfer program in Mexico. It is important to examine whether the program has any direct effect on pregnancy experience and contraceptive use among young rural women, apart from those through education. METHODS: Data from the 1992, 2006 and 2009 waves of a nationally representative, population-based survey were used to describe trends in pregnancy experience, contraceptive use and education amon…
Professional midwifery in Guatemala
Measuring movement towards improved emergency obstetric care in rural Kenya with implementation of the PRONTO simulation and team training program
As the proportion of facility-based births increases, so does the need to ensure that mothers and their newborns receive quality care. Developing facility-oriented obstetric and neonatal training programs grounded in principles of teamwork utilizing simulation-based training for emergency response is an important strategy for improving the quality care. This study uses 3 dimensions of the Kirkpatrick Model to measure the impact of PRONTO Internat…
Improving primary health care delivery in Bihar, India
In 2010, the Bill and Melinda Gates Foundation (BMGF) partnered with the Government of Bihar (GoB), India to launch the Ananya program to improve reproductive, maternal, newborn and child health and nutrition (RMNCHN) outcomes. The program sought to address supply-and demand-side barriers to the adoption, coverage, quality, equity and health impact of select RMNCHN interventions. Approaches included strengthening frontline worker service delivery…
Simulation and team training embedded nurse mentoring programme and improvement in intrapartum and newborn care in a low-resource setting in Bihar, India
Background Improvement of the quality of maternal and child health care remains a focus in India. Working with the Government of Bihar, CARE-India facilitated a comprehensive set of quality of care improvement initiatives. PRONTO's simulation and team-training was incorporated into the largescale Apatkaleen Matritva evam Navjat Tatparta (AMANAT) nurse-mentoring program of the Government of Bihar supported by CARE-India to improve maternal and chi…
Self-reported provision of person-centred maternity care among providers in Kenya and Ghana
INTRODUCTION: Person-centred maternity care (PCMC), which refers to care that is respectful and responsive to women's preferences needs, and values, is core to high-quality maternal and child health. Provider-reported PCMC provision is a potentially valid means of assessing the extent of PCMC and contributing factors. Our objectives are to assess the psychometric properties of a provider-reported PCMC scale, and to examine levels and factors asso…
Provider perceptions of lack of supportive care during childbirth
Supportive care is a key component of person-centered maternity care (PCMC), and includes aspects such as timely and attentive care, pain control, and the health facility environment. Yet, few researchers have explored the degree of supportive care delivered or providers' perceptions on supportive care practices during childbirth. The researchers' aim is to evaluate the extent of supportive care provided to women during childbirth and to identify…
Can digitally enabling community health and nutrition workers improve services delivery to pregnant women and mothers of infants? Quasi-experimental evidence from a national-scale nutrition programme …
BACKGROUND: India's 1.4 million community health and nutrition workers (CHNWs) serve 158 million beneficiaries under the Integrated Child Development Services (ICDS) programme. We assessed the impact of a data capture, decision support, and job-aid mobile app for the CHNWs on two primary outcomes-(1) timeliness of home visits and (2) appropriate counselling specific to the needs of pregnant women and mothers of children <12 months. METHODS: We us…
Effect of a quality improvement intervention for management of preterm births on outcomes of all births in Kenya and Uganda
Background: A large proportion of early neonatal deaths occur at the time or on the first day of birth. The Preterm Birth Initiative East Africa (PTBi EA) set out to decrease mortality among preterm births through improving quality of facility-based intrapartum care. The PTBi EA cluster randomized trial's primary analysis showed the package reduced intrapartum stillbirth and neonatal death among preterm infants. This secondary analysis examines t…
Super Divya, an Interactive Digital Storytelling Instructional Comic Series to Sustain Facilitation Skills of Labor and Delivery Nurse Mentors in Bihar, India—A Pilot Study
To improve the quality of intrapartum care in public health facilities of Bihar, India, a statewide quality improvement program was implemented. Nurses participated in simulation sessions to improve their clinical, teamwork, and communication skills. Nurse mentors, tasked with facilitating these sessions, received training in best practices. To support the mentors in the on-going facilitation of these trainings, we developed a digital, interactiv…
Simulation and team training to improve preterm birth knowledge, evidence-based practices, and communication skills in midwives in Kenya and Uganda
Simulation training in basic and emergency obstetric and neonatal care has previously shown success in reducing maternal and neonatal mortality in low-resource settings. Though preterm birth is the leading cause of neonatal deaths, application of this training methodology geared specifically towards reducing preterm birth mortality and morbidity has not yet been implemented and evaluated. The East Africa Preterm Birth Initiative (PTBi-EA) was a m…
A comic based interactive digital intervention to enhance facilitation skills of nurse mentors in public facilities – results of a pilot intervention in Bihar, India
BACKGROUND: (SD)' to strengthen simulation educator's facilitation knowledge, skills, confidence, and engagement. This endline evaluation presents results on the change in knowledge after watching the episodes and retention of that knowledge over 10 months. OBJECTIVES: The objectives of this pilot study are to: 1) assess the change in knowledge between the baseline and post-episode surveys; and 2) understand the retention of knowledge between the…
Association between coordinated counseling from both Asha and Anganwadi Workers and maternal health outcomes
Community Health Workers (CHWs) play crucial roles in health promotion and services in rural India. Previous research investigating the effectiveness of coordinated health promotion by different community health workers (CHWs) cadres on health practices is scarce. This study examines the effectiveness of coordinated health promotion by different CHW cadres, specifically Accredited Social Health Activists (ASHA) and Anganwadi Workers (AWW), on mat…
A cluster randomized controlled trial to assess the impact of the ‘Caring for Providers to Improve Patient Experience’ (CPIPE) intervention in Kenya and Ghana
ClinicalTrials.gov: NCT06085105. Protocol version and date: v2-11-07-23
A qualitative study of abortion decision-making trajectories among pregnant women at their first antenatal care visit in Kampala, Uganda
Background: In Uganda, only about half of women who want to avoid pregnancy are using modern contraceptives, leading to high numbers of unintended pregnancies and elevated maternal and neonatal morbidity and mortality. In this study, we aimed to learn more about women's abortion decision-making before continuing to carry a pregnancy. Methods: We utilised a qualitative study design and interviewed 31 purposively selected single and partnered pregn…
Medicine (22 works) · Nursing (17 works) · Global Maternal and Child Health (15 works) · Environmental health (12 works) · Population (11 works) · Pregnancy (9 works) · Family medicine (8 works) · Psychology (8 works) · Maternal and Perinatal Health Interventions (7 works) · Health care (6 works)