Kristy M Hackett

McMaster University | McMaster · Institute on Ethics & Policy for Innovation

Background There is limited evidence between contraceptive use, availability of commodities and distance to the facility in developing countries. Distance to the facility is an essential determinant of contraceptive use. Still, women may not seek family planning services from the nearest facility and may be prepared to travel the farthest distance...

Plant breeding plays a crucial role for the EU to live up to its values and promises of sustainability, innovation and diversity and inclusion. The current regulations, however, make it de facto impossible to use new breeding technologies.

Objectives The COVID-19 pandemic has brought significant changes to family life, society and essential health and other services. A rapid review of evidence was conducted to examine emerging evidence on the effects of the pandemic on three components of nurturing care, including responsive caregiving, early learning, and safety and security. Desig...

Objectives To assess the appropriateness of the statistical methodology used in a recent meta-analysis investigating the effect of maternity waiting homes (MWHs) on perinatal mortality in Sub-Saharan Africa. Results A recent meta-analysis published in BMC Research Notes used a fixed-effect model to generate an unadjusted summary estimate of the ef...

Objective: To examine the prevalence and predictors of family planning (FP) know-do gaps among married women of reproductive age (MWRA) in low socio-economic urban areas of Karachi, Pakistan. Design: This was a cross-sectional survey of randomly selected 7288 MWRA (16-49 years) to identify predictors of the know-do gap in FP using a logistic reg...

Background Programmes promoting the postpartum intrauterine device (PPIUD) have proliferated throughout South Asia and sub-Saharan Africa in recent years, with proponents touting this long-acting reversible contraceptive (LARC) method’s high efficacy and potential to meet contraceptive unmet need. While critiques of LARC-first programming abound in...

Introduction: Birth spacing is a critical pathway to improving reproductive health. WHO recommends a minimum of 33-month interval between two consecutive births to reduce maternal, perinatal, infant morbidity and mortality. Our study evaluated factors associated with short birth intervals (SBIs) of less than 33 months between two consecutive birth...

Background Data collection is the most critical stage in any population health study and correctly implementing fieldwork enhances the quality of collected information. However, even the most carefully planned large-scale household surveys can encounter many context-specific issues. This paper reflected on our research team’s recent experience cond...

During the COVID-19 pandemic, there have been drastic changes in family life and programs and services that promote and protect early childhood development. Global stakeholders have raised concerns that the pandemic is putting enormous strain on parents and other caregivers, compromising capabilities and enabling environments for nurturing care of...

Background: Despite increased investment in family planning (FP) programs, Pakistan’s modern contraceptive prevalence rate (mCPR) has not increased in recent years. A better understanding of women’s method preferences and FP decision making in urban contexts may help to inform program and policy development. Methods: We apply a mixed methods design...

CONTEXT Abortion is particularly difficult to measure, especially in legally restrictive settings such as Pakistan. The List Experiment—a technique for measuring sensitive health behaviors indirectly—may minimize respondents’ underreporting of abortion due to stigma or legal restrictions, but has not been previously applied to estimate abortion pre...

Community-based demand-generation family planning programmes have been associated with increased contraceptive use in rural areas of Ghana. However, rigorous evaluations of such programmes in urban contexts are lacking. We used a retrospective, cross-sectional with comparison group design to estimate the immediate and sustained impact of the Willow...

Background: Data collection is the most critical stage in any population health study and correctly implementing fieldwork enhances the quality of collected information. However, even the most carefully planned large-scale household surveys can encounter many context-specific issues. This paper reflected on our research team’s recent experiences of...

Objectives: To assess: (1) the impact of a reproductive health program on modern contraceptive use from baseline to program close; (2) the sustained impact from baseline to follow-up 36 months later; and (3) the exposure-adjusted impact at program close and follow-up. Design: Retrospective, cross-sectional matched control study. Setting: Karac...

Impact of home-based family planning counselling and referral on modern contraceptive use in Karachi, Pakistan: a retrospective, cross-sectional matched control stud

Introduction: Birth spacing is a critical pathway to improving reproductive health. The World Health Organization recommends a minimum of 33-month interval between two consecutive births to reduce maternal, perinatal, and infant morbidity and mortality. Our study evaluated factors associated with short birth intervals (SBIs) of less than 33 months...

Background: This qualitative study assessed implementation of the Postpartum Intrauterine Device (PPIUD) Initiative in Tanzania, a country with high rates of unintended pregnancy and low contraceptive prevalence. The PPIUD Initiative was implemented to reduce unmet need for contraception among new mothers through postpartum family planning counseli...

CONTEXT: Many community-based reproductive health programs use their program data to monitor progress toward goals. However, using such data to assess programmatic impact on outcomes such as contraceptive use poses methodological challenges. Inverse probability weighting (IPW) may help overcome these issues. METHODS: Data on 33,162 women collected...

Despite the numerous benefits of the postpartum copper intrauterine device (PPIUD), which is inserted within 48 hours after giving birth, it is underutilized in many resource‐constrained settings, including Tanzania. We conducted in‐depth interviews with 20 pregnant women who received contraceptive counseling during routine antenatal care in 2016–2...

Mobile health (mHealth) applications have been developed for community health workers (CHW) to help simplify tasks, enhance service delivery and promote healthy behaviours. These strategies hold promise, particularly for support of pregnancy and childbirth in low-income countries (LIC), but their design and implementation must incorporate CHW clien...

Background Adolescents are especially vulnerable due to increased biological, social and economic risks associated with early pregnancy and childbirth, yet most pregnancy and childbirth-related complications are preventable through a combination of proven, cost-effective clinical interventions including timely antenatal care (ANC). The voices and s...

Background About half of births in rural Tanzania are assisted by skilled providers. Point-of-care mobile phone applications hold promise in boosting job support for community health workers aiming to ensure safe motherhood through increased facility delivery awareness, access and uptake. We conducted a controlled comparison to evaluate a smartphon...

Community health workers (CHW) are touted as a cornerstone of primary healthcare delivery in resource-constrained settings due to their linking of individuals to formal healthcare systems. However, in an era of emphasis on “patient-centered care” within the global health community, focus on the well being of frontline health workers is often an aft...

Infant feeding and caregiving by adolescent girls and young women in rural Bangladesh remains relatively understudied despite high potential vulnerability of younger mothers and their children due to poverty and high rates of early marriage and childbearing. This key knowledge gap may hamper the effectiveness of maternal, infant and child health in...

Ensuring access to safe facility-based delivery (FBD) services is a challenge in rural Tanzania, where 50% of women deliver at home, without assistance from trained clinicians. If properly supported, community health workers (CHW) may improve women’s demand for and uptake of FBD. Point-of-care mobile phone applications have potential to aid CHW wit...

Rationale: Frontline community health workers (CHW) have immense potential to improve maternal, newborn and child heath (MNCH), particularly in hard-to-reach communities. Their performance, however, can be limited by weak delivery of appropriate training, unsupportive supervision and ineffective job aids. The emerging field of mobile health (mHea...

Improved infant and young child feeding (IYCF) practices have the potential to improve child health and development outcomes in poorly resourced communities. In Bangladesh, approximately 60% of rural girls become mothers before the age of 18, but most interventions to improve IYCF practices target older mothers. We investigated the knowledge, attit...