Gary L Darmstadt
Dados Biográficos
| ID | 1724837 |
|---|---|
| NOME | Gary L Darmstadt |
| PRENOMES | Gary L |
| SOBRENOME | Darmstadt |
| ASSINATURA | DARMSTADT G L |
| AFILIAÇÕES | Stanford University |
| ORCID | 0000-0002-7522-5824 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 86 |
| TOTAL DE CITAÇÕES | 89 |
| TOTAL COMO AUTOR | 86 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1990 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 6 |
Uncovering hidden patterns
Introduction: Longitudinal trends in breastfeeding (BF) are often overlooked in favor of binary or time-to-cessation measures. Characterizing these trends can inform promotion of sustained BF practices. We identified distinct BF profiles among participants of a maternal and child health program. Methods: = 949) of maternal-reported infant feeding using dynamic time warping. For each month, participants were categorized as either exclusive breastf…
Implementation of essential newborn care in settings of high-intensity armed conflict
INTRODUCTION: A disproportionate share of global neonatal deaths occurs in armed-conflict settings, where progress in reducing neonatal mortality remains slow. This systematic review aims to synthesise the literature on implementing essential newborn care (ENC) interventions in high-intensity armed conflict settings. METHODS: We searched PubMed, CINAHL, Embase and the grey literature from January 2014 to March 2024. Eligible original studies in E…
Causes and risk factors for deaths in young infants in South Asia
INTRODUCTION: Strategies for reducing infant mortality require accurate, local, population-level data. We conducted a population-based observational study in three countries in South Asia to describe risk factors, causes and rates of mortality in young infants. METHODS: Pregnancies, births and pregnancy outcomes were determined through household surveillance, and cause of deaths was ascertained by verbal autopsy. Cox regression was used to identi…
Changes in rural China’s caregiver outcomes, behaviours, and health services utilisation following the Covid-19 pandemic
Background: Under-resourced communities in rural China have long faced limitations in accessing and utilising caregiver and child healthcare (CCH). The COVID-19 pandemic exacerbated health inequities globally, while its precise impacts on CCH remain understudied. We report differences in parental migration, maternal mental health, household and nutrition expenditures, child feeding practices, and prenatal, postnatal, and childbirth care following…
Gender mainstreaming at 25 years
Background: Gender mainstreaming has been central to the development agenda for advancing gender equality globally for nearly three decades. We examined key learning across gender mainstreaming models and experiences and assess key successes and challenges in actualising gender mainstreaming's transformative potential, in order to inform future research agendas. Methods: We reviewed 27 years of peer-reviewed literature on gender mainstreaming (19…
Maternal empowerment, feeding knowledge, and infant nutrition
Background: Maternal empowerment - the capacity to make decisions within households - is linked to better child feeding and nutritional outcomes, but few studies have considered the mediating role of caregiver knowledge. Further, existing literature centres primarily on the husband-wife dyad while overlooking grandmothers as important childcare decision-makers. Methods: We collected primary data through household surveys in 2019 and 2021 from 119…
Legal pluralism and tribalism
The United Nations Convention on the Elimination of all Forms of Discrimination Against Women was adopted on 3 September 1981, committing the signing countries to the advancement of women’s status by ‘guaranteeing them the exercise and enjoyment of human rights and fundamental freedoms on a basis of equality with men’ [1]. Four decades later, despite [...]
Gender norms in a context of legal pluralism
To achieve Sustainable Development Goal 5 for gender equality by 2030, it is crucial for health and development professionals and governmental officials to understand how legal systems empower or oppress populations on the basis of gender worldwide, including opportunities and challenges of statutory provisions created by legal pluralism. Using Ethiopia as a case study, this paper examines how local laws applied in Sharia and Customary Dispute Re…
Strengthening theories of change in women’s group interventions to improve learning
Background: Supporting women's groups is increasingly seen as an important intervention strategy for advancing women's empowerment, economic outcomes, and family health in low- and middle-income countries. We argue that learning from investments in women's group platforms is often limited by the lack of a well-articulated, evaluable theory of change (ToC) developed by those designing the programmes. Methods: We first identify a simple set of step…
Risk factors for community-acquired bacterial infection among young infants in South Asia
OBJECTIVE: Risk factors predisposing infants to community-acquired bacterial infections during the first 2 months of life are poorly understood in South Asia. Identifying risk factors for infection could lead to improved preventive measures and antibiotic stewardship. METHODS: Five sites in Bangladesh, India and Pakistan enrolled mother-child pairs via population-based pregnancy surveillance by community health workers. Medical, sociodemographic …
Real world external validation of metabolic gestational age assessment in Kenya
Using data from Ontario Canada, we previously developed machine learning-based algorithms incorporating newborn screening metabolites to estimate gestational age (GA). The objective of this study was to evaluate the use of these algorithms in a population of infants born in Siaya county, Kenya. Cord and heel prick samples were collected from newborns in Kenya and metabolic analysis was carried out by Newborn Screening Ontario in Ottawa, Canada. P…
Improving the precision of maternal, newborn, and child health impact through geospatial analysis of the association of contextual and programmatic factors with health trends in Bihar, India
Background: There is a scarcity of research that comprehensively examines programme impact from a context-specific perspective. We aimed to determine the conditions under which the Bihar Technical Support Programme led to more favourable outcomes for maternal and child health in Bihar. Methods: We obtained block-level data on maternal and child health indicators during the state-wide scale-up of the pilot Ananya programme and data on health facil…
Optimised emollient mixture for skin barrier repair
INTRODUCTION: IMPORTANCE OF SKIN BARRIER HOMEOSTASIS Maintenance of epidermal permeability barrier homeostasis is required for life in a desiccating, often hostile, terrestrial environment. Children over six months of age and adults who are armed with robust metabolic machinery readily cope with most external stressors [1]. In contrast, individuals with sub-optimal permeability barriers – including the [...]
Gender and the impact of Covid-19 on demand for and access to health care
Background: Global health emergencies can impact men and women differently due to gender norms related to health care and social and economic disruptions. We investigated the intersectionality of gender differences of the impact of COVID-19 on health care access with educational and socio-economic factors in Kenya, Nigeria, and South Africa. Methods: Data were collected by Opinion Research Business International using census data as the sampling …
Paediatric use of emergency medical services in India
Background: Millions of children in low- and middle-income countries (LMICs) experience illness or trauma amenable to emergency medical interventions, but local resources are not sufficient to treat them. Emergency medical services (EMS), including ambulance transport, bridge the gap between local services and higher-level hospital care, and data collected by EMS could be used to elucidate patterns of paediatric health care need and use. Here we …
Quantitative decision making for investment in global health intervention trials
Background: Partners from an NGO, academia, industry and government applied a tool originating in the private sector - Quantitative Decision Making (QDM) - to rigorously assess whether to invest in testing a global health intervention. The proposed NEWBORN study was designed to assess whether topical emollient therapy with sunflower seed oil in infants with very low birthweight <1500 g in Kenya would result in a significant reduction in neonatal …
Unlocking the global health potential of dried blood spot cards
A key challenge to providing care for newborn infants in low- and middle-income countries (LMICs) is the lack of timely diagnostic testing due to weak local infrastructures such as laboratory capacity and imaging technologies. To address this challenge, low-cost diagnostic testing that does not require extensive laboratory processing or costly storage procedures has been prioritised. [...]
Social normative origins of the taboo gap and implications for adolescent risk for HIV infection in Zambia
Zambian Demographic and Health Survey data reveal that increased discordance between professed attitudes and measures of behaviour regarding premarital sex among adults is strongly associated with increased risk of HIV in adolescents, particularly girls. We hypothesised that this was due to the reluctance to talk about premarital sex, resulting in a situation we call the "taboo gap" where sexual behaviour is a forbidden topic and adolescents feel…
Innovative methods to analyse the impact of gender norms on adolescent health using global health survey data
Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health
BACKGROUND: Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, a…
Scaling up Kangaroo Mother Care in Ethiopia and India
OBJECTIVES: Kangaroo Mother Care (KMC), prolonged skin-to-skin care of the low birth weight baby with the mother plus exclusive breastfeeding reduces neonatal mortality. Global KMC coverage is low. This study was conducted to develop and evaluate context-adapted implementation models to achieve improved coverage. DESIGN: This study used mixed-methods applying implementation science to develop an adaptable strategy to improve implementation. Forma…
Implementing health communication tools at scale
INTRODUCTION: As part of an investment by the Bill & Melinda Gates Foundation to support the Government of Bihar to improve reproductive, maternal, newborn and child health and nutrition (RMNCHN) statewide, BBC Media Action implemented multiple communication tools to support front-line worker (FLW) outreach. We analyse the impacts of a package of mHealth audio messaging and paper-based job aids used by FLWs during government-sponsored village hea…
Gender-related data missingness, imbalance and bias in global health surveys
Global surveys have built-in gender-related biases associated with data missingness across the gender dimensions of people’s lives, imbalanced or incomplete representation of population groups, and biased ways in which gender information is elicited and used. While increasing focus is being placed on the integration of sex-disaggregated statistics into national programmes and on understanding effects of gender-based disparities on the health of a…
Africa is not a museum
The Nurturing Care Framework for Early Childhood Development urges stakeholders to implement strategies that help children worldwide achieve their developmental potential. Related programmes range from the WHO’s and UNICEF’s Care for Child Development intervention, implemented in 19 countries, to locally developed programmes, such as non-governmental organisation Tostan’s Reinforcement of Parental Practices in Senegal. However, some researchers a…
Centering and humanising health systems
In an effort to truly understand the power of KMC, one of us (MW) provided KMC for an infant for just one hour at the Veerangana Avanti Bai Women's Hospital in Lucknow (Figure This wonderfully overwhelming experience is beyond description, and here we adopt a personal ("I') voice in an attempt to convey the impact that it had
Developing the “120 by 20” Goal for the Global FP2020 Initiative
This report describes the purpose for developing a quantitative goal for the London Summit on Family Planning held in July 2012, the methodology behind its formulation, and the lessons learned in the process. The London Summit has evolved into the global initiative known as FP2020, and the goal has become “120 by 20,” or reaching 120 million additional users of modern contraceptive methods by 2020 in the world's poorest countries. The success of …
These are not good things for other people to know
The role of piped water supplies in advancing health, economic development, and gender equality in rural communities
Does addressing gender inequalities and empowering women and girls improve health and development programme outcomes
This article presents evidence supporting the hypothesis that promoting gender equality and women's and girls' empowerment (GEWE) leads to better health and development outcomes. We reviewed the literature across six sectors-family planning (FP); maternal, newborn and child health (MNCH); nutrition; agriculture; water, sanitation and hygiene; and financial services for the poor-and found 76 studies from low and middle-income countries that met ou…
Saving newborn lives in Asia and Africa
BACKGROUND: Policy makers and programme managers require more detailed information on the cost and impact of packages of evidenced-based interventions to save newborn lives, particularly in South Asia and sub-Saharan Africa, where most of the world's 4 million newborn deaths occur. METHODS: We estimated the newborn deaths that could be averted by scaling up 16 interventions in 60 countries. We bundled the interventions in a variety of existing ma…
NGO facilitation of a government community-based maternal and neonatal health programme in rural India
Socio-economic disparities in health have been well documented around the world. This study examines whether NGO facilitation of the government's community-based health programme improved the equity of maternal and newborn health in rural Uttar Pradesh, India. A quasi-experimental study design included one intervention district and one comparison district of rural Uttar Pradesh. A household survey conducted between January and June 2003 establish…
Community-Based Child Abuse Prevention
Prematurity, congenital abnormalities, intrauterine growth retardation, and perinatal illness often impair parent-infant attachment, which can contribute to subsequent child abuse. Enhancement of parent-infant relationships, parental coping skills, and social support systems through parent education and home visitation has been shown to reduce the incidence of abuse and is emphasized in the child abuse prevention program proposed in this article.…
Newborn survival
The first month of a baby’s life is surrounded by emotion and new experiences. The mother and father are learning how to be parents, interpreting and responding to the myriad of different cries, sounds and movements. Parents everywhere are concerned that their new baby is warm, safe and feeds well. The first month is one of soaring hopes and possibilities. Yet that month, and especially the birth and first few days after, carries the highest risk…
Innovative methods to analyse the impact of gender norms on adolescent health using global health survey data
Men’s Attitude Towards Contraception and Sexuality, Women’s Empowerment, and Demand Satisfied for Family Planning in India
Whilst the prevalence of unmet need and contraceptive use remained unchanged for 10 years (between 2005-2015) in India, gender restrictive norms and power imbalances also have persisted, preventing married women from meeting their family planning desires. Data for this study are from the 2015-6 National Family Household Survey, which contains information on fertility preferences and family planning for women in reproductive age. As a proxy for me…
Effect of knowledge of community health workers on essential newborn health care
BACKGROUND: This study explored the relationship between the knowledge of community health workers (CHWs)-anganwadi workers (AWWs) and auxiliary nurse midwives (ANMs)-and their antenatal home visit coverage and effectiveness of the visits, in terms of essential newborn health care practices at the household level in rural India. METHODS: We used data from 302 AWWs and 86 ANMs and data from recently delivered women (RDW) (n=13,023) who were reside…
Social normative origins of the taboo gap and implications for adolescent risk for HIV infection in Zambia
Zambian Demographic and Health Survey data reveal that increased discordance between professed attitudes and measures of behaviour regarding premarital sex among adults is strongly associated with increased risk of HIV in adolescents, particularly girls. We hypothesised that this was due to the reluctance to talk about premarital sex, resulting in a situation we call the "taboo gap" where sexual behaviour is a forbidden topic and adolescents feel…
Forecasting burden of long-term disability from neonatal conditions
INTRODUCTION: The burden of disease resulting from neonatal conditions is substantial in developing countries. From 2003 to 2005, the Projahnmo I programme delivered community-based interventions for maternal and newborn health in Sylhet, Bangladesh. This analysis quantifies burden of disability and incorporates non-fatal outcomes into cost-effectiveness analysis of interventions delivered in the Projahnmo I programme. METHODS: A decision tree mo…
Community-Based Child Abuse Prevention
Prematurity, congenital abnormalities, intrauterine growth retardation, and perinatal illness often impair parent-infant attachment, which can contribute to subsequent child abuse. Enhancement of parent-infant relationships, parental coping skills, and social support systems through parent education and home visitation has been shown to reduce the incidence of abuse and is emphasized in the child abuse prevention program proposed in this article.…
Evidence-based, cost-effective interventions
Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries
Background. Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now compri…
Impact of packaged interventions on neonatal health
A disproportionate burden of infant and under-five childhood mortality occurs during the neonatal period, usually within a few days of birth and against a backdrop of socio-economic deprivation in developing countries. To guide programmes aimed at averting these 4 million annual deaths, recent reviews have evaluated the efficacy and cost-effectiveness of individual interventions during the antenatal, intrapartum and postnatal periods in reducing …
Effect of community-based behaviour change management on neonatal mortality in Shivgarh, Uttar Pradesh, India
Setting Priorities in Global Child Health Research Investments
This article provides detailed guidelines for the implementation of systematic method for setting priorities in health research investments that was recently developed by Child Health and Nutrition Research Initiative (CHNRI). The target audience for the proposed method are international agencies, large research funding donors, and national governments and policy-makers. The process has the following steps: (i) selecting the managers of the proce…
Effect of community-based newborn-care intervention package implemented through two service-delivery strategies in Sylhet district, Bangladesh
Differentials in neonatal mortality in two adjacent rural areas of Bangladesh
A household survey, conducted in three rural sub-districts of northeastern Bangladesh, revealed a markedly lower neonatal mortality rate (NMR) in one sub-district compared to two adjacent sub-districts. This study examines the degree to which the differential in NMR can be explained by factors that could be improved by maternal and newborn health programmes, such as knowledge of danger signs and use of antenatal, delivery, and postnatal care. Use…
Saving newborn lives in Asia and Africa
BACKGROUND: Policy makers and programme managers require more detailed information on the cost and impact of packages of evidenced-based interventions to save newborn lives, particularly in South Asia and sub-Saharan Africa, where most of the world's 4 million newborn deaths occur. METHODS: We estimated the newborn deaths that could be averted by scaling up 16 interventions in 60 countries. We bundled the interventions in a variety of existing ma…
NGO facilitation of a government community-based maternal and neonatal health programme in rural India
Socio-economic disparities in health have been well documented around the world. This study examines whether NGO facilitation of the government's community-based health programme improved the equity of maternal and newborn health in rural Uttar Pradesh, India. A quasi-experimental study design included one intervention district and one comparison district of rural Uttar Pradesh. A household survey conducted between January and June 2003 establish…
Traditional birth attendants in rural Nepal
Efforts to formalise the role of traditional birth attendants (TBAs) in maternal and neonatal health programmes have had limited success. TBAs' continued attendance at home deliveries suggests the potential to influence maternal and neonatal outcomes. The objective of this qualitative study was to identify and understand the knowledge, attitudes and practices of TBAs in rural Nepal. Twenty-one trained and untrained TBAs participated in focus grou…
Household surveillance of severe neonatal illness by community health workers in Mirzapur, Bangladesh
BACKGROUND: Effective and scalable community-based strategies are needed for identification and management of serious neonatal illness. METHODS: As part of a community-based, cluster-randomized controlled trial of the impact of a package of maternal-neonatal health care, community health workers (CHWs) were trained to conduct household surveillance and to identify and refer sick newborns according to a clinical algorithm. Assessments of newborns …
These are not good things for other people to know
Vulnerability of Newborns to Environmental Factors
Infection is the major cause of neonatal deaths. Home born newborns in rural Bangladeshi communities are exposed to environmental factors increasing their vulnerability to a number of disease agents that may compromise their health. The current analysis was conducted to assess the association of very severe disease (VSD) in newborns in rural communities with temperature, rainfall, and humidity. A total of 12,836 newborns from rural Sylhet and Mir…
Newborn survival
The first month of a baby’s life is surrounded by emotion and new experiences. The mother and father are learning how to be parents, interpreting and responding to the myriad of different cries, sounds and movements. Parents everywhere are concerned that their new baby is warm, safe and feeds well. The first month is one of soaring hopes and possibilities. Yet that month, and especially the birth and first few days after, carries the highest risk…
Effect of knowledge of community health workers on essential newborn health care
BACKGROUND: This study explored the relationship between the knowledge of community health workers (CHWs)-anganwadi workers (AWWs) and auxiliary nurse midwives (ANMs)-and their antenatal home visit coverage and effectiveness of the visits, in terms of essential newborn health care practices at the household level in rural India. METHODS: We used data from 302 AWWs and 86 ANMs and data from recently delivered women (RDW) (n=13,023) who were reside…
Clean cord care practices and neonatal mortality
BACKGROUND: About a million newborns die each year in India, accounting for about a fourth of total global neonatal deaths. Infections are among the leading causes of neonatal mortality. Care practices immediately following delivery contribute to newborns' risk of infection and mortality. OBJECTIVES: This study examined the association between clean cord care practices and neonatal mortality in rural Uttar Pradesh, India. METHODS: The study used …
Forecasting burden of long-term disability from neonatal conditions
INTRODUCTION: The burden of disease resulting from neonatal conditions is substantial in developing countries. From 2003 to 2005, the Projahnmo I programme delivered community-based interventions for maternal and newborn health in Sylhet, Bangladesh. This analysis quantifies burden of disability and incorporates non-fatal outcomes into cost-effectiveness analysis of interventions delivered in the Projahnmo I programme. METHODS: A decision tree mo…
Sex differences in neonatal mortality in Sarlahi, Nepal
BACKGROUND: Studies in South Asia have documented increased risk of neonatal mortality among girls, despite evidence of a biological survival advantage. Associations between gender preference and mortality are cited as reasons for excess mortality among girls. This has not, however, been tested in statistical models. METHODS: A secondary analysis of data from a population-based randomised controlled trial of newborn infection prevention conducted…
Newborn health
Despite advances in issue-attention and in evidence of what works to save newborn lives (e.g., kangaroo mother care, antenatal corticosteroids, immediate and exclusive breastfeeding), we are still falling short on impact. To advance the unfinished newborn survival agenda, newborns must become an integral priority in developing countries where the burden of neonatal mortality is highest. Interventions must be adapted to local contexts and cultures…
Developing the “120 by 20” Goal for the Global FP2020 Initiative
This report describes the purpose for developing a quantitative goal for the London Summit on Family Planning held in July 2012, the methodology behind its formulation, and the lessons learned in the process. The London Summit has evolved into the global initiative known as FP2020, and the goal has become “120 by 20,” or reaching 120 million additional users of modern contraceptive methods by 2020 in the world's poorest countries. The success of …
Taking on the gender challenge in organisations
Clear patterns emerged and are summarised on conditions for success in integrating a gender equality perspective across organisational programmes and culture. In short, organisations should consider five key ‘ingredients’ when designing their approach to integrating a gender equality perspective: (1) have a clear vision of success with measurable indicators; (2) have high-level, consistent, visible support; (3) take an intentional approach deeply…
Does addressing gender inequalities and empowering women and girls improve health and development programme outcomes
This article presents evidence supporting the hypothesis that promoting gender equality and women's and girls' empowerment (GEWE) leads to better health and development outcomes. We reviewed the literature across six sectors-family planning (FP); maternal, newborn and child health (MNCH); nutrition; agriculture; water, sanitation and hygiene; and financial services for the poor-and found 76 studies from low and middle-income countries that met ou…
Investing in the foundation of sustainable development
Early childhood development
Medicine (71 obras) · Global Maternal and Child Health (51 obras) · Environmental health (47 obras) · Population (39 obras) · Political science (37 obras) · Nursing (32 obras) · Child Nutrition and Water Access (28 obras) · Psychology (24 obras) · Sociology (24 obras) · Psychological intervention (23 obras)