Marleen Temmerman

Marleen Temmerman
Aga Khan University Hospital, Nairobi · Department of Obstetrics and Gynecology

Professor

About

875
Publications
265,479
Reads
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32,931
Citations
Additional affiliations
December 2015 - present
Aga Khan University East-Africa
Position
  • Managing Director
October 2012 - present
World Health Organization WHO
Position
  • Managing Director
October 1994 - October 2012
Ghent University
Position
  • Head of Department

Publications

Publications (875)
Article
Full-text available
Introduction Previous surveys of male sex workers (MSW) in sub-Saharan Africa have not fully documented the HIV and sexually transmitted infections (STIs) rates and vulnerabilities by age category. Methods The bio-behavioral survey of MSW in Nairobi, Kenya, utilized respondent-driven sampling to recruit MSW. Structured interviews captured MSW's be...
Article
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Background Maternal psychological stress has been linked to preterm birth. However, the differential contribution of psychological stress versus stress hormones is not clear. Studies focus primarily on perceived stress and cortisol, with few assessing its inter-convertible hormone cortisone. Furthermore, little is known about the potential moderati...
Article
Full-text available
Background: Delivery of quality reproductive health services has been documented to depend on the availability of healthcare workers who are adequately supported with appropriate training. However, unmet training needs among healthcare workers in reproductive, maternal, and newborn health (RMNH) in low-income countries remain disproportionately hi...
Article
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We urgently need answers to basic epidemiological questions regarding SARS-CoV-2 infection in pregnant and postpartum women and its effect on their newborns. While many national registries, health facilities, and research groups are collecting relevant data, we need a collaborative and methodologically rigorous approach to better combine these data...
Article
Despite recent efforts from governments and international organizations to promote adolescent sexual and reproductive health (SRH) rights, some of the current policies fall short of achieving the desired outcomes because of a failure to understand adolescent emerging needs and capacity, the diversity of adolescent populations, and the recognition t...
Article
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Background There is substantial evidence that immunization is one of the most significant and cost-effective pillars of preventive and promotive health interventions. Effective childhood immunization coverage is thus essential in stemming persistent childhood illnesses. The third dose of pentavalent vaccine for children is an important indicator fo...
Article
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Background Female sex workers (FSW) and men having sex with men (MSM) in Kenya have high rates of HIV infection. Following a 2015 WHO recommendation, Kenya initiated national scale-up of pre-exposure prophylaxis (PrEP) for all persons at high-risk. Concerns have been raised about PrEP users' potential changes in sexual behaviors such adopting condo...
Article
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Background: Mothers may access medical facilities for their babies and miss opportunities to access family planning (FP) services. This study was undertaken to describe missed opportunities for FP among women within the extended (0-11 months) postpartum period from counties participating in Performance Monitoring and Accountability 2020 (PMA2020)...
Preprint
Improving access to family planning (FP) is associated with positive health benefits that includes averting nearly a third of all maternal deaths and 10% of childhood deaths. Kenya has made great strides in improving access to family planning services. However, amid this considerable progress, regional variation has been noted. Methods We conducted...
Article
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Objectives The objective of this randomised controlled trial in Kenya was to assess the effect of delivering sexual and reproductive health (SRH) information via text message to young people on their ability to reject contraception-related myths and misconceptions. Design and setting A three-arm, unblinded randomised controlled trial with a ratio...
Article
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Introduction: The first exposure to high-risk sexual and drug use behaviors often occurs during the period of youth (15-24 years old). These behaviors increase the risk of HIV infection, especially among young key populations (KP)-men how have sex with men (MSM), female sex workers (FSW), and people who inject drugs (PWID). We describe the charact...
Preprint
BACKGROUND Ultrasound for gestational age (GA) assessment is not routinely available in resource-constrained settings, particularly in rural and remote locations. The TraCer device combines a handheld wireless ultrasound probe and a tablet with Artificial Intelligence (AI)-enabled software that obtains GA from videos of the fetal head by automated...
Article
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Background: In Pakistan, there is a clear imbalance between the population's needs and available resources to cater for spacing and limiting childbirth as desired by couples. More than two-thirds (70%) of the Pakistani population are now paying out-of-pocket for overall health costs. Public sector in South Asia is the main player in service provisi...
Preprint
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Background Teenage marriage and adolescent pregnancy present a significant health challenge in the Tanzania. About 36% of women aged 15-49 are married before the age of 18, and 32% of rural adolescents (10-19 years) gave birth, compared with 19% of urban. In Mwanza region, one third of currently married adolescent and women aged 15-49 experienced u...
Article
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A cesarean section (CS) can be a lifesaving intervention when medically indicated, but it may also lead to adverse short- and long-term health effects for women and children.
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Background A significant shortage of healthcare workforce exists globally. To achieve Universal Healthcare coverage, governments need to enhance their community-based health programmes. Community health volunteers (CHVs) are essential personnel in achieving this objective. However, their ability to earn a livelihood is compromised by the voluntary...
Article
Purpose Around one in five girls in Kenya, aged 15 to 19 years old are either pregnant or have given birth. Of 47 counties, adolescent pregnancy is highest in Narok, where about 40% of girls aged 15 to 19 years old have begun childbearing. This study aims to explore drivers to sexual activity, access to sexual and reproductive health (SRH) services...
Article
Importance Persistence of cervical high-risk human papillomavirus (hrHPV) after treatment for cervical intraepithelial neoplasia grade 2 or higher (CIN2+) has not been compared between cryotherapy and loop electrosurgical excision procedure (LEEP) among HIV-positive women. Objective To evaluate whether cryotherapy or LEEP is more effective at clea...
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Background Continuous professional development (CPD) has been reported to enhance healthcare workers’ knowledge and skills, improve retention and recruitment, improve the quality of patient care, and reduce patient mortality. Therefore, validated training needs assessment tools are important to facilitate the design of effective CPD programs. Meth...
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Background: Globally, male involvement in reproductive, maternal, newborn, and child health (RMNCH) is associated with increased benefits for women, their children, and their communities. Between 2016 and 2020, the Aga Khan University implemented the Access to Quality of Care through Extending and Strengthening Health Systems (AQCESS), project fund...
Preprint
Full-text available
Background Delivery of quality reproductive health services has been documented to depend on the availability of healthcare workers who are adequately supported with appropriate training. However, unmet training needs among healthcare workers in reproductive, maternal, and newborn health (RMNH) in low-income countries remain disproportionately high...
Article
Full-text available
Background There is a global emphasis on engaging community health volunteers (CHVs) in low- to middle-income countries (LMICs) to reach to the vast underserved populations that live in rural areas. Retention of CHVs in most countries has however been difficult and turnover in many settings has been reported to be high with profound negative effect...
Article
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Antenatal stress has been associated with adverse birth outcomes such as fetal growth restriction, low birth weight, and preterm birth. Understanding key determinants of stress in a vulnerable pregnant population has the potential of informing development of targeted cost-effective interventions to mitigate against these adverse birth outcomes. We...
Article
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Background: In China, there were about 9.76 million induced abortions in 2019, 50% of which were repeat abortions. Understanding the tendency of repeat induced abortion and identifying its related factors is needed to develop prevention strategies. Methods: Two hospital-based cross-sectional surveys were conducted from 2005-2007 and 2013-2016 in...
Article
Full-text available
Male involvement in reproductive, maternal, newborn and child health (RMNCH) is known to improve maternal and child health outcomes. However, there is sub-optimal adoption of male involvement strategies in several low- and middle-income countries such as Kenya. Aga Khan University implemented Access to Quality of Care through Extending and Strength...
Article
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Background Demand for family planning met/satisfied with modern contraceptive methods (mDFPS) has been proposed to track progress in Family Planning (FP) programs for Sustainable Development Goals. This study measured mDFPS among married women of reproductive age (MWRA) in Kenya to identify which groups were not being reached by FP programs.Materia...
Article
Background People who use drugs (PWUD) which includes both people who inject drugs (PWID) and non-injection drug users (NIDU) are marginalized, experience high levels of stigma and discrimination, and are likely to have challenges with accessing health services. Mozambique implemented the first drop-in center (DIC) for PWUD in Maputo City in 2018....
Article
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Background In western Kenya, women often present with late-stage cervical cancer despite prior contact with the health care system. The aim of this study was to predict primary health care providers’ behaviour in examining women who present with abnormal discharge or bleeding. Methods This was a cross-sectional survey using the theory of planned b...
Article
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Background Stress and burnout among healthcare workers has been recognized as a global crisis needing urgent attention. Yet few studies have examined stress and burnout among healthcare providers in sub-Saharan Africa, and even fewer among maternity providers who work under very stressful conditions. To address these gaps, we examined self-reported...
Preprint
Full-text available
Background: Uterine Fibroid Embolization (UFE) is one of the effective options available for treatment of symptomatic uterine fibroids with documented improvement in the quality of life and reduction in symptoms. Most of the studies have demonstrated an improvement in the quality of life over a short to intermediate period. We carried out this stud...
Preprint
Full-text available
BACKGROUND Globally, male involvement in reproductive, maternal, newborn and child health (RMNCH) is associated with increased benefits for women, their children, and their communities. Between 2016 and 2020, the Aga Khan University has been implementing the Access to Quality of Care through Extending and Strengthening Health Systems (AQCESS), proj...
Article
Objectives: To report the proportion and determinants of repeat induced abortions in China. Methods: Cross-sectional data were collected of 79 954 women who received an induced abortion from 297 hospitals across 30 Chinese provinces in 2013, using a stratified cluster sampling design. Logistic and Poisson regression models were fitted to identif...
Article
Full-text available
Objectives Portugal has the highest HIV incidence rate in Western Europe. The proportion assigned to sexual contact between men recently increased to more than 30% of all HIV infections. Men who have sex with men (MSM) are vulnerable to the acquisition of other sexually transmitted infections (STIs), increasing the per-contact risk of HIV infection...
Article
Full-text available
Setting Kenya, 2012–2015 Objective To explore whether there is a gender difference in all-cause mortality among smear positive pulmonary tuberculosis (PTB)/ HIV co-infected patients treated for tuberculosis (TB) between 2012 and 2015 in Kenya. Design Retrospective cohort of 9,026 smear-positive patients aged 15–49 years. All-cause mortality durin...
Preprint
Full-text available
Background: Stress and burnout among healthcare workers has been recognized as a global crisis needing urgent attention. Yet few studies have examined stress and burnout among healthcare providers in sub-Saharan Africa, and even fewer among maternity providers who work under very stressful conditions. To address these gaps, we examined self-reporte...
Preprint
Full-text available
Background There is substantial evidence that immunization is one of the most significant and cost-effective pillars of preventive and promotive health interventions. Effective childhood immunization coverage is thus essential in stemming persistent childhood illnesses. The main indicator of performance of the immunisation programme is the third do...
Article
Full-text available
Background: Premarital sex practices and contraceptive prevalence rate (CPR) among unmarried women worldwide remain unclear, even though unmarried women tend to have multiple sex partners over time, which makes their sexual behaviors particularly important to the sexual and reproductive health of society more broadly. Methods: We searched the ME...
Article
Over 20 years, interventions have targeted HIV among female sex workers (FSWs) in Kenya given their central role in new infections. To determine the effects of these interventions, we assessed the prevalence and correlates of HIV among a random sample of FSWs and modelled prevalence estimates from studies since 1993. FSWs aged 16–34 years were enro...
Article
Full-text available
Background Female sex workers in low-income and middle-income countries face high risks of unintended pregnancy. We developed a 12-month, multifaceted short messaging service intervention (WHISPER) for female sex workers in Kenya who had the potential to become pregnant, to improve their contraceptive knowledge and behaviours. The aim of this study...
Preprint
Full-text available
Background Globally, male involvement in reproductive, maternal, newborn and child health (RMNCH) is associated with increased benefits for women, their children, and their communities. Between 2016 and 2020, the Aga Khan University has been implementing the Access to Quality of Care through Extending and Strengthening Health Systems (AQCESS), proj...
Preprint
Full-text available
Background Healthcare delivery globally and particularly in low-income setting is challenged by multiple, complex and dynamic problems. The reproductive, maternal and newborn health (RMNH) care is among the most affected areas resulting into high maternal and neonatal mortality and morbidity across the Sub Saharan region and Tanzania in particular....
Preprint
Full-text available
Background: Healthcare delivery globally and particularly in low-income setting is challenged by multiple, complex and dynamic problems. The reproductive, maternal and newborn health (RMNH) care is among the most affected areas resulting into high maternal and neonatal mortality and morbidity across the Sub Saharan region and Tanzania in particular...
Article
Full-text available
While disrespectful treatment of pregnant women attending health care facilities occurs globally, it is more prevalent in low-resource countries. In Kenya, a large body of research studied disrespectful maternity care (DMC) from the perspective of the service users. This paper examines the perspective of health care workers (HCWs) on factors that i...
Article
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Background Technological advances and high throughput biological assays can facilitate discovery science in biobanks from population cohorts, including pregnant women. Biological pathways associated with health outcomes differ depending on geography, and high-income country data may not generalise to low-resource settings. We conducted a systematic...
Article
Full-text available
Background Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication rea...
Article
Full-text available
There remain a number of uncertainties globally about the risks posed to women who are infected with SARS-CoV-2 during pregnancy. Furthermore, our understanding of the spread of COVID-19 in Sub-Saharan Africa is limited, owing to low testing rates in many parts of the continent. PeriCOVID Africa, in conjunction with the WHO/HRP Alliance, plans to a...
Article
Objective: Health facility-based delivery is associated with reduced maternal mortality. This study explores barriers to utilization of health facility-based delivery in Kenya. Methods: In April 2017, a qualitative study utilizing key informant interviews (KII) and focus group discussions (FGDs) was carried out in Bomachoge Borabu and Kaloleni,...
Preprint
Full-text available
Background: There is a significant shortage of healthcare workforce globally. In order to achieve Universal Healthcare coverage, governments need to enhance their community-based healthcare provider programmes. Community health volunteers (CHVs) are essential personnel in achieving this objective, however their needs remain unmet hence their high a...
Preprint
Full-text available
Background There is substantial evidence that immunization is one of the most significant and cost-effective pillars of preventive and promotive health interventions. Effective childhood immunization coverage is thus essential in stemming persistent childhood illnesses. The main indicator of performance of the immunisation programme is the third do...
Preprint
Full-text available
Background There is substantial evidence that immunization is one of the most significant and cost-effective pillars of preventive and promotive health interventions. Effective childhood immunization coverage is thus essential in stemming persistent childhood illnesses. The main indicator of performance of the immunisation programme is the third do...
Preprint
Full-text available
Background: Maternal and infant morbidity and mortality remain high in the world and particularly in sub-Saharan Africa. However, actions to strengthen postpartum care are still weak and mainly limited to health facilities (HFs). The Missed Opportunities in Mother and Infant Health (MOMI) project implemented in the Kaya health district in Burkina F...
Article
Full-text available
In 2017, the Government of Mozambique declared localized acute malnutrition crises in a range of districts across Mozambique including Cabo Delgado. This is in spite of intensive efforts by different non-governmental organizations (NGO) and the Government of Mozambique to expand access to information on good nutritional practices as well as promote...
Article
Full-text available
Background: Key populations - men who have sex with men (MSM), female sex workers (FSW) and people who inject drugs (PWID) - are at high risk for sexually transmitted infections (STI) given their sexual risk behaviours along with social, legal and structural barriers to prevention, care and treatment services. The purpose of this secondary analysi...
Preprint
Full-text available
Background: Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication re...
Preprint
Full-text available
Introduction: Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication...
Preprint
Full-text available
Introduction: Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication...
Preprint
Full-text available
Background: Pre-exposure prophylaxis (PrEP) is a biomedical approach for preventing the acquisition of HIV in populations at substantial risk for HIV. PrEP acceptability has been high among the men who have sex with men (MSM) but the uptake and adherence has been low. The study seeks to determine the determinants of PrEP uptake among the MSM. Meth...
Article
Full-text available
Background: There is no consensus on the role of inflammatory markers in identifying chorioamnionitis in preterm prelabour rupture of membranes (PPROM). We set out to evaluate the accuracy of maternal blood C-reactive protein (CRP), procalcitonin and interleukin 6 (IL6) in diagnosis of histological chorioamnionitis and/or funisitis (HCA/Funisitis)...
Preprint
Full-text available
Background: Family planning plays an important role in reducing high-risk and unwanted pregnancies and associated complications. Kenya has made progress increasing the use of modern contraceptives. We assessed inequalities in contraceptive use and family planning demand satisfied. Methods: We used data from seven rounds of Performance, Monitoring a...