Cheryl A Moyer

University of Michigan | U-M · Department of Learning Health Sciences and OBGYN

Background Delayed diagnosis of preeclampsia contributes to maternal morbidity and mortality. Patient-performed home blood pressure monitoring facilitates more frequent monitoring and earlier diagnosis. However, challenges may exist to implementation in low- and middle income-countries. Methods This cross-sectional mixed methods study evaluated ob...

Background Understanding biological causes of death and sociocultural factors influencing outcomes is critical to reducing mortality in low-resource settings. Verbal and Social Autopsy instruments (VASAs) query family members about events leading to an individual’s death, resulting in quantitative, categorical data. This study sought to determine t...

Objective: To explore how clinicians in low- and middle-income countries engage and support parents following newborn death. Study design: Qualitative interviews of 40 neonatal clinicians with diverse training were conducted in Addis Ababa, Ethiopia and Kumasi, Ghana. Transcribed interviews were analyzed and coded through the constant comparativ...

Background While group antenatal care (ANC) has been delivered and studied in high-income countries for over a decade, it has only recently been introduced as an alternative to individual care in sub-Saharan Africa. Although the experimental design of the studies from high-resource countries have been scientifically rigorous, findings cannot be gen...

Background Maternal mortality has a multifaceted impact on families, especially in low- and middle-income countries, where rates of maternal mortality are high and resources can be lacking. The objective of this study was to explore the ways that maternal mortality influences the physical and emotional wellbeing, financial stability, and caregiving...

Introduction This paper aims to describe and assess social demographic factors associated with childbearing decision-making, fertility and contraceptive intentions among street adolescents and youth in Kampala, Uganda while considering rural-urban migration as an explanatory factor. Materials and Methods A cross-sectional survey of 513 adolescents...

Preeclampsia and eclampsia are common and serious complications of pregnancies, often presenting as obstetric emergencies. In low- and middle-income countries, limited numbers of healthcare providers and a high volume of critically ill patients can negatively impact provider communication and counseling. Lack of knowledge or awareness of preeclamps...

Background Despite the vulnerabilities associated with the youth migration process, knowledge on the drivers of risky sexual behaviour among migrant street youth is limited. This study sought to explore the pathways driving risky sexual behaviour among rural–urban migrant street youth in Kampala, Uganda. Methods We conducted 11 focus-group discuss...

COVID-19 has uniquely impacted pregnant women. From the initial unknowns about its virulence during pregnancy, to frequent and rapidly changing hospital guidelines for prenatal care and delivery, pregnant women have felt intense uncertainty and, based on recent research, increased anxiety. This study sought to determine the impact COVID-19 had on w...

BACKGROUND Worldwide, hypertensive disorders of pregnancy are a serious complication of pregnancy, and contribute to poor maternal and neonatal outcomes. The most significant consequences of hypertensive disorders of pregnancy are observed in sub-Saharan Africa, where neonatal outcomes have not been fully described. Understanding relationships betw...

Abstract Background Globally, 94% of malaria deaths occur in sub-Saharan Africa, and children under age 5 account for 70% of malaria-related mortality in the region. This study sought to examine differences between female-headed households (FHHs) and male-headed households (MHHs) with regard to malaria prevention and testing among children under ag...

Background Maternity waiting homes, usually located in rural, low-resource settings, may increase access to skilled care during delivery and ultimately improve maternal-newborn outcomes. Although there are studies exploring maternity waiting homes in rural settings, little is known about interest in and viability of maternity waiting home use in ur...

Background Maternal mortality has a significant global impact, especially in low-resource settings. Little prior research has been conducted on the potential effects of poor maternal outcomes on the personal and professional well-being of healthcare providers. This study explores the in-depth experiences and perspectives of obstetric providers in G...

Background Understanding biological causes of death and sociocultural factors that influence survival outcomes is crucial to reducing mortality in low-resource settings. Verbal and Social Autopsy instruments (VASAs) query family members about events leading up to an individual's death, resulting in quantitative, categorical data. We aimed to determ...

Background In high income countries, guidelines exist recommending gestational age thresholds for offering and obligating neonatal resuscitation for extremely preterm infants. In low- and middle- income countries, this approach may be impractical due to limited/inconsistent resource availability and challenges in gestational dating. Scant literatur...

AimsThis study sought to assess factors associated with the justification of Intimate Partner Violence (IPV) among men in sub-Saharan Africa using data from 27 countries.Methods The study used data from the male file of the most current Demographic and Health Surveys (DHSs) conducted in 27 countries in sub-Saharan Africa. Men aged 15–64 years were...

Background This paper aimed at describing childbearing decision-making, fertility and contraceptive intentions and associated social demographic factors among disadvantaged street adolescents and youth in Kampala, Uganda while considering rural-urban migration aspects as an explanatory factor. Methods A cross-sectional survey of 513 adolescents an...

Objectives Low birthweight (LBW) is a significant public health problem in sub-Saharan Africa and LBW in rural Zambia is high. Our study explored the prevalence of LBW for newborns whose mothers were referred from a rural health center to a district referral hospital in Lundazi, Zambia.MethodsA five-month retrospective record review of Ministry of...

Neonatal mortality is one of the leading causes of under-five mortality globally, with the majority of these deaths occurring in low- and middle-income countries. In Ghana, there is a belief in an array of newborn conditions, called Asram, that are thought to have a spiritual, rather than physical, cause. These conditions are predominantly managed...

Introduction People with sickle cell disease (SCD) often face stigmatization in Ghana and elsewhere in Africa. Research is needed to understand whether it is necessary to design an SCD stigma reduction program in the Ghanaian setting. The aim of this study was to explore the perception of stigmatization for adults with SCD in Kumasi, Ghana. Method...

Background and Purpose An exploratory latent class analysis (LCA) was performed assessing the association between maternity waiting home (MWH) use and maternal–newborn care knowledge. Methods A two-group comparison design using a face-to-face interview ( n = 250) was conducted to understand if MWH use was associated with greater maternal knowledge...

Background More than a third of pregnant women in Africa use medicinal plants (hereafter, ‘herbs’) during pregnancy, yet little is known about herb use among urban African women, or about the potential impact on newborns. Methods This cross-sectional study of 504 women giving birth at an urban government hospital in Kumasi, Ghana (May–July 2018) c...

Background Although under-five (U5) mortality in Uganda has dropped over the past two decades, rates in urban slum neighborhoods remain high. As part of a broader verbal and social autopsy study of U5 deaths, this study explored the perspectives of volunteer community health workers, called Village Health Teams (VHTs), on why children under five in...

Objective This study explored providers’ perspectives and behavior regarding respectful maternity care, including knowledge, attitudes, and practices. Design Mixed-methods cross-sectional study combining quantitative survey data, qualitative interviews, and observations of labor and delivery across four health facilities Setting Government health...

Objective: To explore if and how women perceived their prenatal care to have changed as a result of COVID-19 and the impact of those changes on pregnant women. Design: Qualitative analysis of open-ended prompts included as part of an anonymous, online, cross-sectional survey of pregnant women in the United States. Setting: Online survey with partic...

Background While the nexus of migration and health outcomes is well acknowledged, the effect of rural–urban migration on the use of sexual and reproductive health (SRH) services has received less attention. We assessed the effect of rural–urban migration on the use of SRH services, while controlling for confounding, and whether there is a differenc...

While research on the nexus of migration and wellbeing of individuals has gained recognition in recent years, far less attention has been devoted to intra-urban mobility especially among the urban poor young populations. We assess the drivers of intra-urban mobility using a random sample of 412 migrant street children and youth in Kampala city, Uga...

Objectives: The Three Delays Model outlines three common delays that lead to poor newborn outcomes: (1) recognizing symptoms and deciding to seek care; (2) getting to care and; (3) receiving timely, high-quality care. We gathered data for all newborn deaths within four districts in Ghana to explore how well the Three Delays Model explains outcomes...

Background The 2013–2016 Ebola Virus Disease (EVD) outbreak remains the largest on record, resulting in the highest mortality and widest geographic spread experienced in Africa. Ghana, like many other African nations, began screening travelers at all entry points into the country to enhance disease surveillance and response. This study aimed to ass...

Globally, sickle cell disease (SCD) is a common, yet often neglected, non-communicable disease. Community health worker (CHW) interventions have been shown to improve outcomes for chronic diseases but have not been evaluated with SCD. This study assessed the interest in and feasibility of establishing a network of CHWs to support care of people wit...

Objective: This study explores the impacts of managing frequent maternal mortalities on obstetric health care providers in Ghana. Methods: Two hundred seventy obstetric providers at the Komfo Anokye Teaching Hospital in Ghana completed an electronic survey. Questions included coping strategies, sources and adequacy of support, training, and emot...

Pregnant women in Ghana report skipping antenatal care and reconsidering facility delivery due to concerns about COVID‐19.

Introduction Although vaccination coverage is high in Kenya relative to other African nations, undervaccinated children remain, making it important to identify characteristics of these children and their caregivers. Potentially relevant but understudied factors are women's empowerment and early marriage. Women who marry older and have more autonomo...

The aim of this study is to explore the impact of the COVID-19 pandemic on pregnant women’s anxiety and identify factors most strongly associated with greater changes in anxiety. An anonymous, online, survey of pregnant women (distributed April 3–24, 2020) included a modified pregnancy-related anxiety scale (PRAS) reflecting respondents’ perception...

Background Preeclampsia/eclampsia is a major cause of maternal morbidity and mortality worldwide, yet patients’ perspectives about their diagnosis are not well understood. Our study examines patient knowledge among women with preeclampsia/eclampsia in a large urban hospital in Ghana. Methods Postpartum women diagnosed with preeclampsia or eclampsi...

Introduction Sickle cell disease (SCD) stigma is a major community health issue. The challenges of caring for someone with SCD can be overwhelming. We explored stigma and related factors for caregivers of pediatric patients with SCD in Kumasi, Ghana. Method Guided by the Ecological Systems Theory, we used in-depth interviews with a semistructured...

Preeclampsia/eclampsia is a major complication of pregnancy in developing countries. [1, 2] Whilst the existing literature focuses on the epidemiological and clinical aspects, the present study explores patient experience with preeclampsia/eclampsia among women in Ghana.

Maternity waiting homes (MWHs) may offer an intervention to improve newborn outcomes in rural Zambia. This study compared maternal knowledge of newborn care for women referred from facilities with and without MWHs. Topics assessed included: (1) umbilical cord care; (2) thermal and skin care; (3) nutrition, and; (4) prevention of diarrhea, and; (5)...

Ghana has made progress in expanding providers in abortion care but access to the service is still a challenge. We explored stakeholder perspectives on task‐sharing in abortion care and the opportunities that exist to optimize this strategy in Ghana. We purposively sampled 12 representatives of agencies that played a key role in expanding abortion...

Purpose: To explore the impact of the COVID-19 pandemic on pregnant women’s anxiety and identify factors most strongly associated with greater changes in anxiety. Methods: An anonymous, online, survey of pregnant women (distributed April 3 - 24, 2020) included a modified Pregnancy-Related Anxiety Scale (PRAS) reflecting respondents’ perception of p...

While overall neonatal mortality rates are improving in Ghana, the Ashanti Region has the highest mortality rate in the country. The clinical causes of newborn deaths are well known, yet local beliefs about illness aetiology, cause of death and care-seeking are less well understood. This exploratory qualitative study sought to understand how commun...

Objective Descriptions of maternity waiting homes (MWHs) as an intervention to increase facility delivery for women living in remote geographic areas dates back to the 1950s, yet there is limited information on the scale-up and sustainability of MWHs. The objective of this study was to describe the evolutionary scale-up of MWHs as a component of he...

Background: Global health experiences are an increasingly popular component of medical student curricula. There is little research on the impact of international medical electives embedded within long-standing, sustainable partnerships. Our research explores the University of Michigan medical student elective experience in Ghana within the context...

Introduction: A wide gap in knowledge exists about the factors associated with newborn care in rural Zambia. In this year of the nurse and midwife, the purpose of this article is to provide transcultural researchers with an example of how Bronfenbrenner’s Ecological Systems Theory (EST) can be used to guide an exploration of the cultural practices,...

Background While the nexus of migration and health outcomes is well acknowledged, the effect of rural-urban migration on uptake of sexual and reproductive health (SRH) services has received less attention. We assessed the effect of rural-rural urban migration on uptake of SRH services and whether there is a difference in uptake of SRH services amon...

Background: While the nexus of migration and health outcomes is well acknowledged, the effect of rural-urban migration on use of sexual and reproductive health (SRH) services has received less attention. We assessed the effect of rural-rural migration on the use of SRH services while controlling for confounding and whether there is a difference in...

Background: While the nexus of migration and health outcomes is well acknowledged, the effect of rural-urban migration on use of sexual and reproductive health (SRH) services has received less attention. We assessed the effect of rural-rural migration on the use of SRH services while controlling for confounding and whether there is a difference in...

(BJOG. 2019;126:755–762) In 2015, the maternal mortality ratio in Ghana was 350 deaths per 100,000 live births, nearly twice the target of <185 per 100,000 live births. As the maternal mortality ratio drops, the near-miss morbidity may become an important measure of quality of care. The incidence of maternal near-misses is unknown but has been esti...

Maternity waiting homes (MWHs) in Liberia promote facility‐based delivery to reduce maternal mortality. However, women often must bring their own food and supplies to MWHs, which makes food insecurity a barrier to the utilisation of MWHs. Consumption of edible indigenous insects is a common practice and has notable nutritional benefits but has not...

Background - Far too many newborns die or face serious morbidity in Zambia, as in many other sub-Saharan African countries. New knowledge is needed to enhance our understanding of newborn care and the cultural factors influencing the ways mothers seek newborn care. This study adds to the literature about rural Zambians’ cultural beliefs and practic...

Objective: Rates of maternal and neonatal death remain high in the Global South, especially in Sub-Saharan Africa. In addition, indicators vary significantly by geography. This study aimed to understand what communities in northern Ghana with frequent maternal and newborn deaths or near deaths (near-misses) perceive to be the causes. As part of a...

Abstract Background For every newborn who dies within the first month, as many as eight more suffer life-threatening complications but survive (termed ‘neonatal near-misses’ (NNM)). However, there is no universally agreed-upon definition or assessment tool for NNM. This study sought to describe the development of the Neonatal Near-Miss Assessment T...

Background: For every newborn who dies within the first month, as many as eight more suffer life-threatening complications but survive (termed ‘neonatal near-misses’ (NNM)). However, there is no universally agreed-upon definition or assessment tool for NNM. This study sought to describe the development of the Neonatal Near-Miss Assessment Tool (NNM...

Objective Geospatial data are used by health systems and researchers to understand disease burdens, trace outbreaks, and allocate resources, however, there are few well-documented protocols for collecting and analyzing geographic information systems data in rural areas of low- and middle-income countries. Even with the proliferation of spatial tech...

For every newborn who dies within the first month, as many as eight more suffer life-threatening complications but survive (termed ‘neonatal near-misses’ (NNM)). However, there is no universally agreed-upon definition or assessment tool for NNM. This study sought to describe the development of the Neonatal Near-Miss Assessment Tool (NNMAT) for low-...

Background Few evidence‐based interventions exist on how to improve respectful maternity care (RMC) in low‐resource settings. We sought to evaluate the effect of an integrated simulation‐based training on provision of RMC. Methods The pilot project was in East Mamprusi District in northern Ghana. We integrated specific components of RMC, emphasizi...

Background For every newborn who dies within the first month after birth, as many as eight more suffer life-threatening complications but survive. Such events, termed ‘neonatal near-misses’, are becoming increasingly important indicators for epidemiologic surveillance and quality of care assessment. However, to date, there is no universally agreed-...

Background: For every newborn who dies within the first month, as many as eight more suffer life-threatening complications but survive (termed ‘neonatal near-misses’ (NNM)). However, there is no universally agreed-upon definition or assessment tool for NNM. This study sought to describe the development of the Neonatal Near-Miss Assessment Tool (NNM...

Neonatal morbidity and mortality remain a significant challenge in Ghana. Given the relationship between care-seeking and understanding of illness, this study aimed to explore mothers’ perceptions of the cause of illness and/or death in Northern Ghana. All neonatal deaths and near-misses (babies who survived a life-threatening complication) in 2015...

Objective: In this study, we sought to determine to what extent the abortion law in Ghana is reflective of public opinion. Methods: In a cross-sectional, community-based survey, individuals in two fishing communities in Accra were interviewed about their beliefs on abortion between May and July 2016, and sociodemographic, attitudinal, and experi...

Objectives: We compared pregnancy identification methods and outcome capture across 31 Health Demographic Surveillance System (HDSS) sites in 14 countries in sub-Saharan Africa and Asia. Methods: From 2009 to 2014, details on the sites and surveillance systems including frequency of update rounds, characteristics of enumerators and interviewers, ac...

Objectives We compared pregnancy identification methods and outcome capture across 31 Health Demographic Surveillance System (HDSS) sites in 14 countries in sub-Saharan Africa and Asia. Methods From 2009 to 2014, details on the sites and surveillance systems including frequency of update rounds, characteristics of enumerators and interviewers, acc...

Previous research has described the evil eye as a source of illness for pregnant women and their newborns. This study sought to explore the perceptions of the evil eye among mothers whose newborns had experienced a life-threatening complication across three regions of Ghana. As part of a larger, quantitative study, trained research assistants ident...

Objective: To explore the incidence and factors associated with maternal near-miss. Design: Cross-sectional study with an embedded case-control study. Setting: Three tertiary referral hospitals in southern Ghana. Population: All women admitted to study facilities with pregnancy-related complications or for birth. Methods: An adapted versio...

Background: Globally, an estimated two million women have undergone Female Genital Mutilation (FGM), and approximately four percent of women who have been circumcised live in Ghana. In the Bawku Municipality and Pusiga District, sixty one percent of women have undergone the procedure. This study therefore aimed at identifying the factors that sust...

Background: Person-centred maternity care (PCMC) is maternity care that is responsive to and respectful of women's needs and values. It is a key dimension of quality, capturing the experience of interpersonal dimensions of care. Poor PCMC contributes to high maternal mortality not only directly but also indirectly through decreased demand for servi...

Objective: To explore basic and comprehensive emergency obstetric service provision across four districts in rural northern Ghana, and whether women were more likely to deliver at facilities with more skilled care. Methods: Field workers geo-coded all health facilities in East Mamprusi, Sissala East, Kassena Nankana Municipal, and Kassena Nankan...

Background Several qualitative studies have described disrespectful, abusive, and neglectful treatment of women during facility-based childbirth, but few studies document the extent of person-centred maternity care (PCMC)—ie, responsive and respectful maternity care—in low-income and middle-income countries. In this Article, we present descriptive...

Background: Women comprise 75% of the health workforce in many countries and the majority of students in academic global health tracks but are underrepresented in global health leadership. This study aimed to elucidate prevailing attitudes, perceptions, and beliefs of women and men regarding opportunities and barriers for women’s career advancement...

Background: Globally, three million girls are at risk of female genital mutilation (FGM) and an estimated 200 million girls and women in the world have undergone FGM. While the overall prevalence of FGM in Ghana is 4%, studies have shown that the overall prevalence in the Upper East Region is 38%, with Bawku municipality recording the highest at 82...