Karen Marie Moland
Dados Biográficos
| ID | 165607 |
|---|---|
| NOME | Karen Marie Moland |
| PRENOMES | Karen Marie |
| SOBRENOME | Moland |
| ASSINATURA | MOLAND K M |
| AFILIAÇÕES | University of Bergen |
| ORCID | 0000-0003-1491-8595 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 36 |
| TOTAL DE CITAÇÕES | 53 |
| TOTAL COMO AUTOR | 36 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2004 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 5 |
Navigating an ambiguous abortion terrain in Addis Ababa, Ethiopia
Ethiopia liberalized its abortion law in 2004 and issued technical guidelines in 2006 to expand access to legal and safe abortion services. However, the implementation of this progressive policy is shaped by stigma, patriarchal norms, and influential actors. As a result, women seeking abortion are required either to negotiate these power dynamics or to go through unsafe procedures. Despite this policy overhaul, there is a paucity of data on how w…
Legal issues in the implementation of Maternal Death Surveillance and Response
The Maternal Death Surveillance and Response (MDSR) system is designed to continuously identify and review all maternal deaths. It aims to help countries understand the scale and distribution of maternal deaths, identify their causes, and inform corrective measures to address the challenge. Despite the growing adoption of the MDSR by numerous low- or middle-income countries, its implementation faces various challenges, including legal ones. This …
There is nowhere to take the child’
The participants were concerned about childhood alcohol and substance use, but the complexity and magnitude of the problem left them feeling incapacitated in responding. Relevant factors were identified on the community, institutional, and the government level, such as a lack of leadership in addressing it, a loss of mandate to interfere in child-rearing, inadequate services, weak legal structures, and missing government action. A strengthening o…
As soon as they can hold a glass, they begin taking alcohol’
To our knowledge, this is the first study to describe the context and conditions of childhood substance use before age 10 in Mbale District, Uganda. The study shows that community members attributed early childhood substance use to a social context of widespread use in the community, which was exacerbated by conditions of material and emotional deprivation. These social determinants for this practice deserve public health attention and interventi…
Norms and sexual relations among adolescents in the context of an intervention trial in rural Zambia
High levels of adolescent pregnancy and child marriage rates in low- and middle-income countries is an issue of concern to many stakeholders, including in Zambia where almost one-third of women give birth before age 18. The aim of this paper is to explore and analyse social norms concerning adolescents' sexual behaviour within the context of an intervention trial in rural communities in southern Zambia. It is based on a qualitative study applying…
Vanilla bisquits and lobola bridewealth
Grasping the complexity of local discourse is vital in planning health interventions. The present study revealed that although delayed child bearing and schooling among girls enjoyed high status and legitimacy in the study area, the social and economic context worked to reward early marriage. Interventions to reduce early pregnancies in rural Zambian communities need to fundamentally address the material constraints that condition and reinforce a…
Juridification of maternal deaths in Ethiopia
Juridification of maternal health care is on the rise globally, but little is known about its manifestations in resource constrained settings in sub-Saharan Africa. The Maternal and Perinatal Death Surveillance and Response (MPDSR) system is implemented in Ethiopia to record and review all maternal and perinatal deaths, but underreporting of deaths remains a major implementation challenge. Fear of blame and malpractice litigation among health wor…
Silent politics and unknown numbers
This article addresses the gaps between knowledge, policy and practice in reproductive health by exploring the processes involved in translating Zambian abortion policy from paperwork to practice in a predominantly rural province. Central to these processes are rural health bureaucrats, who are tasked with administering and monitoring a myriad of reproductive health policies and programmes. The articles is based on eleven months of ethnographic f…
When abortion becomes public - Everyday politics of reproduction in rural Zambia
This article takes the public reaction to the discovery of an aborted foetus in a rural Zambian community as the empirical starting point for exploring the everyday politics of reproduction. It builds on eleven months of ethnographic fieldwork on abortion and abortion policy in Zambia in 2017 and 2018, including participant observation in the community where the episode took place and interviews with clinic staff and neighbours. The article explo…
Beyond the law
Misoprostol has during the past few years become an important obstetric drug used for different purposes both within and outside hospitals in Tanzania. In this paper, we analyze how misoprostol is perceived, accessed and used off-label as an abortion drug in the city and region of Dar es Salaam. The study took place in Dar es Salaam's three districts from July to November 2015, and had a qualitative explorative approach. We carried out in-depth i…
Why teach sexuality education in school? Teacher discretion in implementing comprehensive sexuality education in rural Zambia
The CSE had limited legitimacy in the community and was met with resistance from teachers tasked with its' implementation. In order to enhance ownership to the CSE program, local concerns about the contents of the curriculum and the parent-teacher role dilemma must be taken into consideration. Not addressing these challenges may undermine the policy's intention of increasing knowledge about sexuality and reproduction and empowering adolescents to…
Shaping the abortion policy – competing discourses on the Zambian termination of pregnancy act
We argue that the Zambian Termination of Pregnancy Act is ambiguous and leaves much room for interpretation. This paper challenges the notion that the Zambian abortion law is liberal and opens up for further discussion on the relationship between how a law is described and perceived by the public, and the rights to health and services ensured by it
An uneasy compromise’
While silence as a strategy works to protect the law enhancing the health and survival of young women, it may at the same time prevent the law from being fully effective. As a long term strategy, silence fails to expand awareness and access to safe abortion services, and may not sufficiently serve to fulfill the potential of the law to prevent abortion related maternal deaths
The access paradox
Legal frameworks are vital instruments for securing the right to health, but broad contextualized studies rather than classifications of law along a liberal-restrictive continuum are demanded in order to enhance existing knowledge on access to safe abortion services in a given context
Maternal deaths should simply be 0’
The Maternal Death Surveillance and Response system (MDSR) was implemented in Ethiopia in 2013 to record and review maternal deaths. The overall aim of the system is to identify and address gaps in order to prevent future death but, to date, around 10% of the expected number of deaths are reported. This article examines practices and reasoning involved in maternal death reporting and review practices in Ethiopia, building on the concept of 'pract…
How do health professionals acknowledge Web-based knowledge in pregnancy consultations
Websites for pregnancy health are an important source of information for pregnant women, but how different cadres of health professionals value and utilize pregnant women's e-health literacy (e-HL) and Web-based knowledge in pregnancy consultations is not well understood. Using a qualitative research design and pelvic girdle pain as a tracer condition, we explored how Norwegian doctors, midwives and physiotherapists manage women's e-HL and Web-ba…
Policy, paperwork and 'postographs
Targets and indicators set at the global level are powerful tools that govern health systems in low-income countries. Skilled birth attendance at a health facility is an important indicator for monitoring maternal mortality reduction worldwide. This paper examines how health workers negotiate policy implementation through the translation of clinical care into registries and reports. It does so by analysing the links between the global policy of i…
What if the baby doesn't survive? Health-care decision making for ill newborns in Ethiopia
Despite efforts to improve access to and quality of care for newborns, the first month after birth remains the most dangerous period of life. Given high neonatal mortality in low-income countries, saving newborn lives is a key priority for global and national health policy agendas. However, little is known about how these policies resonate with local understandings, experiences and household priorities. In this qualitative study we examined famil…
The inescapable question of fairness in Pay-for-performance bonus distribution
BACKGROUND: During the last decade there has been a growing concern about the lack of results in the health sectors of many low income countries. Progress has been particularly slow in maternal- and child health. Prompted by the need to accelerate progress towards these health outcomes, pay-for- performance (P4P) schemes have been initiated in a number of countries. This paper explores the perceptions and experiences of health workers with P4P bo…
Lessons learned from the PMTCT program in Swaziland
Women face a myriad of challenges initiating lifelong ART. Understanding women's concerns will aid in developing effective counseling messages, designing appropriate counseling structures, understanding where additional support is needed in the process of initiating ART, and knowing who to target for community level messages
Introducing payment for performance in the health sector of Tanzania- the policy process
BACKGROUND: Prompted by the need to achieve progress in health outcomes, payment for performance (P4P) schemes are becoming popular policy options in the health systems in many low income countries. This paper describes the policy process behind the introduction of a payment for performance scheme in the health sector of Tanzania illuminating in particular the interests of and roles played by the Government of Norway, the Government of Tanzania a…
The social context of severe child malnutrition
Households that participated in inter-household cooperation were able to improve food and nutrition security. Children living in households with high pressure on productive members were at danger of food insecurity and malnutrition. Nutrition interventions need to involve local institutions for inter-household cooperation and address the problem of social inequalities in service provision. They should have special focus on households with few res…
Reflections on informed choice in resource-poor settings
They Ask Whether This Is Real or Fake”
Women increasingly combine paid work and childbearing, but working full time throughout pregnancy is commonly experienced as overtaxing. We explored access to sick leave or medical care as experienced by Norwegian women suffering from pelvic girdle pain during pregnancy. Through a grounded theory approach we compared results from qualitative interviews and open Internet discussions, and found that women struggled with credibility and that their c…
Assessing performance enhancing tools
BACKGROUND: Health workers' motivation is a key determinant of the quality of health services, and poor motivation has been found to be an obstacle to service delivery in many low-income countries. In order to increase the quality of service delivery in the public sector in Tanzania, the Open Performance Review and Appraisal System (OPRAS) has been implemented, and a new results-based payment system, Payment for performance (P4P) is introduced in…
Policy, paperwork and 'postographs
Targets and indicators set at the global level are powerful tools that govern health systems in low-income countries. Skilled birth attendance at a health facility is an important indicator for monitoring maternal mortality reduction worldwide. This paper examines how health workers negotiate policy implementation through the translation of clinical care into registries and reports. It does so by analysing the links between the global policy of i…
The Varying Vulnerability of African Orphans
This article is based on a qualitative study carried out in Lira District, northern Uganda, to assess the situation of orphans cared for in extended families. The objective of the article is to bring attention to the varying vulnerability of different categories of orphans. The methods employed in data collection included ethnographic fieldwork, qualitative interviews and focus group discussions. The study found that the decision-making process t…
Difficult choices
Infant feeding represents a great challenge in the prevention of mother-to-child transmission of HIV (pMTCT). The international guidelines informing infant feeding counselling suggest feeding methods that reduce the risk of HIV transmission, and discourage mixed feeding (combining breastfeeding with other fluids and solids). The feasibility and the social acceptability of the recommended feeding methods are hotly debated currently. Through the do…
Silent politics and unknown numbers
This article addresses the gaps between knowledge, policy and practice in reproductive health by exploring the processes involved in translating Zambian abortion policy from paperwork to practice in a predominantly rural province. Central to these processes are rural health bureaucrats, who are tasked with administering and monitoring a myriad of reproductive health policies and programmes. The articles is based on eleven months of ethnographic f…
When abortion becomes public - Everyday politics of reproduction in rural Zambia
This article takes the public reaction to the discovery of an aborted foetus in a rural Zambian community as the empirical starting point for exploring the everyday politics of reproduction. It builds on eleven months of ethnographic fieldwork on abortion and abortion policy in Zambia in 2017 and 2018, including participant observation in the community where the episode took place and interviews with clinic staff and neighbours. The article explo…
Beyond the law
Misoprostol has during the past few years become an important obstetric drug used for different purposes both within and outside hospitals in Tanzania. In this paper, we analyze how misoprostol is perceived, accessed and used off-label as an abortion drug in the city and region of Dar es Salaam. The study took place in Dar es Salaam's three districts from July to November 2015, and had a qualitative explorative approach. We carried out in-depth i…
What if the baby doesn't survive? Health-care decision making for ill newborns in Ethiopia
Despite efforts to improve access to and quality of care for newborns, the first month after birth remains the most dangerous period of life. Given high neonatal mortality in low-income countries, saving newborn lives is a key priority for global and national health policy agendas. However, little is known about how these policies resonate with local understandings, experiences and household priorities. In this qualitative study we examined famil…
Technologies of hope? Motherhood, HIV and infant feeding in eastern Africa
A vast number of HIV positive mothers live with a known HIV positive status without an experienced ability to prevent the virus from spreading to their offspring. This article focuses on the dramatic effects on identity and sociality instigated by prevention of mother to child transmission of HIV (PMTCT) programmes, and discusses the potential for the development of HIV related activism linked to programme enrolment. Paying particular attention t…
Reflections on informed choice in resource-poor settings
A Defeat not to Be Ultra-Fit”
Managing work while pregnant has long been a challenge for women in both paid and unpaid work. With Norway as the case in point, the aim of this study was to explore expectations and experiences among women relating to work-life and pregnancy health. Employing the constant comparison method, we drew on interviews, Internet discussions, newspapers, and health information booklets. The findings revealed strong discourses on pregnancy as health, and…
Mother's Milk, An Ambiguous Blessing in the Era of Aids
Mother's Milk, An Ambiguous Blessing in the Bra of Aids
HIVIAIDS has renewed the need for a critical interpretation of hreastfeeding in social and cultural terms. The issue that this study addresses is how medically informed knowledge o_f HIV transmission through breastfeeding is interpreted and transformed in a local rural community in Kilimaryaro Region in northern Tanzania. The paper explores the articulation between a medical discourse on risk and a local dis course on motherhood which infrJrm…
The Varying Vulnerability of African Orphans
This article is based on a qualitative study carried out in Lira District, northern Uganda, to assess the situation of orphans cared for in extended families. The objective of the article is to bring attention to the varying vulnerability of different categories of orphans. The methods employed in data collection included ethnographic fieldwork, qualitative interviews and focus group discussions. The study found that the decision-making process t…
Continuity and Change in Reproductive Attitudes of Teenage Women, Their Mothers, and Maternal Grandmothers in South Africa
During the past couple of decades, as South Africa has undergone a political and social transformation, conditions for reproduction and reproductive health have changed. Against the backdrop of these societal changes, the objectives of this cross-sectional study were to trace continuity and change in reproductive attitudes on an individual level, through three generations of women linked to each other by kin in the Limpopo Province, South Africa.…
Difficult choices
Infant feeding represents a great challenge in the prevention of mother-to-child transmission of HIV (pMTCT). The international guidelines informing infant feeding counselling suggest feeding methods that reduce the risk of HIV transmission, and discourage mixed feeding (combining breastfeeding with other fluids and solids). The feasibility and the social acceptability of the recommended feeding methods are hotly debated currently. Through the do…
Experiences of orphan care in Amach, Uganda
Uganda is estimated to have around two million orphans constituting approximately 19% of all the children in the country. This paper presents findings from a study on the experiences of orphan care among Langi people of Amach sub-county in Lira District, northern Uganda, and discusses their policy implications. The study utilised the following methods in data collection: eight months of ethnographic fieldwork; 21 in-depth interviews with communit…
The context of HIV risk behaviours among HIV-positive injection drug users in Viet Nam
HIV-positive injection drug users continue to practice HIV risk behaviours. The anti-drug law and the police crack-down policy appeared as critical factors hampering ongoing prevention efforts with needle and syringe distribution programmes in Viet Nam. Drastic policy measures are needed to reduce the very high HIV prevalence among injection drug users
Technologies of hope? Motherhood, HIV and infant feeding in eastern Africa
A vast number of HIV positive mothers live with a known HIV positive status without an experienced ability to prevent the virus from spreading to their offspring. This article focuses on the dramatic effects on identity and sociality instigated by prevention of mother to child transmission of HIV (PMTCT) programmes, and discusses the potential for the development of HIV related activism linked to programme enrolment. Paying particular attention t…
A Defeat not to Be Ultra-Fit”
Managing work while pregnant has long been a challenge for women in both paid and unpaid work. With Norway as the case in point, the aim of this study was to explore expectations and experiences among women relating to work-life and pregnancy health. Employing the constant comparison method, we drew on interviews, Internet discussions, newspapers, and health information booklets. The findings revealed strong discourses on pregnancy as health, and…
The potential role of mother-in-law in prevention of mother-to-child transmission of HIV
Decreasing influence of the mother-in-law and increasing prominence of the conjugal couples in issues related to reproduction and child care, reinforce the importance of continued efforts to include male partners in the PMTCT programme. The potential for involving mothers-in-law in the infant feeding component, where she still has influence in some areas, should be further explored
Assessing performance enhancing tools
BACKGROUND: Health workers' motivation is a key determinant of the quality of health services, and poor motivation has been found to be an obstacle to service delivery in many low-income countries. In order to increase the quality of service delivery in the public sector in Tanzania, the Open Performance Review and Appraisal System (OPRAS) has been implemented, and a new results-based payment system, Payment for performance (P4P) is introduced in…
Comparing HIV prevalence estimates from prevention of mother-to-child HIV transmission programme and the antenatal HIV surveillance in Addis Ababa
There were consistent HIV prevalence estimates from PMTCT programme and from antenatal surveillance reports. Both data sources showed a marked decline in HIV prevalence among antenatal care attendees in Addis Ababa. This study concludes that the routine data from the PMTCT programmes in Addis Ababa provides comparable HIV prevalence estimates with antenatal HIV surveillance data and could be used for monitoring trends
They Ask Whether This Is Real or Fake”
Women increasingly combine paid work and childbearing, but working full time throughout pregnancy is commonly experienced as overtaxing. We explored access to sick leave or medical care as experienced by Norwegian women suffering from pelvic girdle pain during pregnancy. Through a grounded theory approach we compared results from qualitative interviews and open Internet discussions, and found that women struggled with credibility and that their c…
Reflections on informed choice in resource-poor settings
Introducing payment for performance in the health sector of Tanzania- the policy process
BACKGROUND: Prompted by the need to achieve progress in health outcomes, payment for performance (P4P) schemes are becoming popular policy options in the health systems in many low income countries. This paper describes the policy process behind the introduction of a payment for performance scheme in the health sector of Tanzania illuminating in particular the interests of and roles played by the Government of Norway, the Government of Tanzania a…
The social context of severe child malnutrition
Households that participated in inter-household cooperation were able to improve food and nutrition security. Children living in households with high pressure on productive members were at danger of food insecurity and malnutrition. Nutrition interventions need to involve local institutions for inter-household cooperation and address the problem of social inequalities in service provision. They should have special focus on households with few res…
The inescapable question of fairness in Pay-for-performance bonus distribution
BACKGROUND: During the last decade there has been a growing concern about the lack of results in the health sectors of many low income countries. Progress has been particularly slow in maternal- and child health. Prompted by the need to accelerate progress towards these health outcomes, pay-for- performance (P4P) schemes have been initiated in a number of countries. This paper explores the perceptions and experiences of health workers with P4P bo…
Lessons learned from the PMTCT program in Swaziland
Women face a myriad of challenges initiating lifelong ART. Understanding women's concerns will aid in developing effective counseling messages, designing appropriate counseling structures, understanding where additional support is needed in the process of initiating ART, and knowing who to target for community level messages
What if the baby doesn't survive? Health-care decision making for ill newborns in Ethiopia
Despite efforts to improve access to and quality of care for newborns, the first month after birth remains the most dangerous period of life. Given high neonatal mortality in low-income countries, saving newborn lives is a key priority for global and national health policy agendas. However, little is known about how these policies resonate with local understandings, experiences and household priorities. In this qualitative study we examined famil…
How do health professionals acknowledge Web-based knowledge in pregnancy consultations
Websites for pregnancy health are an important source of information for pregnant women, but how different cadres of health professionals value and utilize pregnant women's e-health literacy (e-HL) and Web-based knowledge in pregnancy consultations is not well understood. Using a qualitative research design and pelvic girdle pain as a tracer condition, we explored how Norwegian doctors, midwives and physiotherapists manage women's e-HL and Web-ba…
Policy, paperwork and 'postographs
Targets and indicators set at the global level are powerful tools that govern health systems in low-income countries. Skilled birth attendance at a health facility is an important indicator for monitoring maternal mortality reduction worldwide. This paper examines how health workers negotiate policy implementation through the translation of clinical care into registries and reports. It does so by analysing the links between the global policy of i…
Why teach sexuality education in school? Teacher discretion in implementing comprehensive sexuality education in rural Zambia
The CSE had limited legitimacy in the community and was met with resistance from teachers tasked with its' implementation. In order to enhance ownership to the CSE program, local concerns about the contents of the curriculum and the parent-teacher role dilemma must be taken into consideration. Not addressing these challenges may undermine the policy's intention of increasing knowledge about sexuality and reproduction and empowering adolescents to…
Shaping the abortion policy – competing discourses on the Zambian termination of pregnancy act
We argue that the Zambian Termination of Pregnancy Act is ambiguous and leaves much room for interpretation. This paper challenges the notion that the Zambian abortion law is liberal and opens up for further discussion on the relationship between how a law is described and perceived by the public, and the rights to health and services ensured by it
An uneasy compromise’
While silence as a strategy works to protect the law enhancing the health and survival of young women, it may at the same time prevent the law from being fully effective. As a long term strategy, silence fails to expand awareness and access to safe abortion services, and may not sufficiently serve to fulfill the potential of the law to prevent abortion related maternal deaths
The access paradox
Legal frameworks are vital instruments for securing the right to health, but broad contextualized studies rather than classifications of law along a liberal-restrictive continuum are demanded in order to enhance existing knowledge on access to safe abortion services in a given context
Medicine (30 obras) · Nursing (22 obras) · Sociology (22 obras) · Political science (18 obras) · Global Maternal and Child Health (17 obras) · Public health (17 obras) · Environmental health (15 obras) · Pregnancy (13 obras) · Socioeconomics (13 obras) · Psychology (12 obras)